Effect of radiotherapy on local recurrence, distant metastasis and overall survival in 1200 extremity soft tissue sarcoma patients. Retrospective analysis using IPTW-adjusted models

医学 软组织肉瘤 比例危险模型 回顾性队列研究 放射治疗 远处转移 内科学 辅助放疗 肉瘤 低风险 肿瘤科 软组织 转移 外科 癌症 置信区间 病理
作者
Maria Anna Smolle,Dimosthenis Andreou,Judith Wölfel,Ibtissam Acem,Michiel A. J. van de Sande,Lee Jeys,Han J. Bonenkamp,Rob Pollock,Per‐Ulf Tunn,Rick L. Haas,Florian Posch,Robert J. van Ginkel,Cornelis Verhoef,Bernadette Liegl‐Atzwanger,Dalia Moustafa-Hubmer,Philipp J. Jost,Andreas Leithner,Joanna Szkandera
出处
期刊:Radiotherapy and Oncology [Elsevier BV]
卷期号:189: 109944-109944 被引量:3
标识
DOI:10.1016/j.radonc.2023.109944
摘要

Neoadjuvant (NRTX) and adjuvant radiotherapy (ARTX) reduce local recurrence (LR) risk in extremity soft tissue sarcoma (eSTS), yet their impact on distant metastasis (DM) and overall survival (OS) is less well defined. This study aimed at analysing the influence of NRTX/ARTX on all three endpoints using a retrospective, multicentre eSTS cohort.1200 patients (mean age: 60.7 ± 16.8 years; 44.4 % females) were retrospectively included, treated with limb sparing surgery and curative intent for localised, high grade (G2/3) eSTS. 194 (16.2 %), 790 (65.8 %), and 216 (18.0 %) patients had received NRTX, ARTX and no RTX, respectively. For the resulting three groups (no RTX vs. NRTX, no RTX vs. ARTX, NRTX vs. ARTX) Fine&Gray models for LR and DM, and Cox-regression models for OS were calculated, with IPTW-modelling adjusting for imbalances between groups.In the IPTW-adjusted analysis, NRTX was associated with lower LR-risk in comparison to no RTX (SHR [subhazard ratio]: 0.236; p = 0.003), whilst no impact on DM-risk (p = 0.576) or OS (p = 1.000) was found. IPTW-weighted analysis for no RTX vs. ARTX revealed a significant positive association between ARTX and lower LR-risk (SHR: 0.479, p = 0.003), but again no impact on DM-risk (p = 0.363) or OS (p = 0.534). IPTW-weighted model for NRTX vs. ARTX showed significantly lower LR-risk for NRTX (SHR for ARTX: 3.433; p = 0.003) but no difference regarding DM-risk (p = 1.000) or OS (p = 0.639).NRTX and ARTX are associated with lower LR-risk, but do not seem to affect DM-risk or OS. NRTX may be favoured over ARTX as our results indicate better local control rates.
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