Combined modality treatment with distant gamma therapy and intraoperative radiation therapy for patients with soft tissue sarcomas

The combined modality treatment including distant gamma therapy (DGT) and intraoperative radiation therapy (IORT) was administered to 85 patients with soft tissue sarcomas. The study group comprised 60 patients with soft tissue sarcomas who underwent surgery with IORT and received either pre-or postoperative DGT. The control group comprised 25 patients with soft tissue sarcomas who underwent surgery followed by standard DGT at a total dose of 40-45 Gy. Squares of postoperative and preoperative DGT were 220 cm2 and 150 cm2, respectively. The square of IORT was 77 cm2. High levels of TDF factor (up to 145-150 conventional units in 12 % of cases) were observed in patients with soft tissue sarcomas treated with IORT and postoperative DGT. The 5-year recurrence rate was 34 ± 4,7 % in soft tissue sarcoma patients who received IORT and DGT. The corresponding value in the control group was 68 ± 7,3 %. The 5-year overall and recurrence-free survival rates were 65,6 % and 72 % in the study group and 37,8 % and 34,2 % in the control group respectively.