Outcomes of local therapies for recurrent and radiation associated soft tissue sarcomas of the extremities and trunk: is there a role for re-irradiation?
Bibliographic record
Abstract
Background And Purpose Managing locally relapsed soft tissue sarcomas (STS) after prior radiotherapy (RT) and radiation-associated sarcomas (RAS) is challenging. Limb-sparing surgery without repeated RT may be suboptimal in anatomically constrained cases, while amputation compromises function and quality of life. This study evaluates outcomes of patients treated with re-irradiation plus surgery versus surgery alone.Material And Methods This retrospective cohort study included patients treated at a single sarcoma centre (Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto) for locally relapsed STS after prior RT and surgery, or for RAS, diagnosed between October 1985 and August 2024. Treatment and outcome data were analysed to compare local control, limb preservation, complications, distant failure, and overall survival between patients receiving re-irradiation plus surgery versus surgery alone.Results A total of 93 patients with recurrent STS and 13 with RAS were analyzed. RT for re-irradiation was mostly administered preoperatively using a twice-daily (BID) fractionation scheme. The 5-year local control rate for recurrent STS was 82.8 % in the re-irradiation plus surgery group and 67.9 % in the surgery-only group (p = 0.336). The 5-year limb preservation rate was significantly higher with re-irradiation (80.8 %) versus surgery alone (40.2 %) (p < 0.001). Complications requiring intervention were more frequent with re-irradiation for relapses (13/43 vs. 3/50, p = 0.002). Freedom from distant failure and overall survival (OS) at 5 years were similar between the groups (65.1 vs. 71.7 % and 57.3 % vs. 55 %). The 5-year OS after RAS diagnosis was 75.2 %, with five complications, four local failures and four patients developing distant failure during follow-up.Conclusion Re-irradiation combined with surgery represents a viable alternative to amputation or surgery alone in selected patients with locally relapsed STS or RAS, with high rates of limb salvage and acceptable toxicity.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".