Annals of Surgical Oncology

, Volume 21, Issue 8, pp 2484–2489 | Cite as

Efficacy of Adjuvant Radiation Therapy in the Treatment of Soft Tissue Sarcoma of the Extremity: 20-year Follow-Up of a Randomized Prospective Trial

  • Joal D. Beane
  • James C. Yang
  • Donald White
  • Seth M. Steinberg
  • Steven A. Rosenberg
  • Udo Rudloff
Bone and Soft Tissue Sarcomas



This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS).


Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemotherapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan–Meier method.


A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10- and 20-year survival was 77 % (95 % CI 66–85 %) and 64 % (95 % CI 52–75 %) for patients receiving LSS alone and 82 % (95 % CI 72–90 %) and 71 % (95 % CI 59–81 %) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 % (1 of 24) in the LSS alone cohort compared with 0 % (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 %, p = 0.72), clinically significant edema (25 vs. 12 %, p = 0.31), and functional limb deficits (15 vs. 12 %, p = 0.84).


Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.


Overall Survival Soft Tissue Sarcoma External Beam Radiation Therapy Wound Complication Limb Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.





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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Joal D. Beane
    • 1
  • James C. Yang
    • 1
  • Donald White
    • 1
  • Seth M. Steinberg
    • 2
  • Steven A. Rosenberg
    • 1
  • Udo Rudloff
    • 1
  1. 1.Surgery BranchNational Cancer InstituteBethesdaUSA
  2. 2.Biostatistics and Data Management Section, Center for Cancer ResearchNational Cancer InstituteBethesdaUSA

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