Adjuvant radiation therapy in extremity soft tissue sarcomas decreases the rate of local recurrence. In a level 1 study by Yang et al, patients with soft tissue sarcomas of the extremity were randomized to receive or not receive radiation therapy following excision. No difference in overall survival rate was reported. The group receiving radiation had a lower rate of local recurrence, but also had transient loss of strength and range of motion. In another level 1 study by O'Sullivan et al, patients with soft tissue sarcomas of the extremity were randomized to pre-operative or post-operative radiation therapy. While the rate of local recurrence was not significantly different between those patients receiving pre-operative vs post-operative radiotherapy, 30% of patients who received pre-operative radiotherapy experienced significant wound complications. The incidence of radiation induced morbidity and the concern for radiation induced sarcoma was significantly greater in the post-operative radiotherapy group.
Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, DeLaney T, Glatstein E, Steinberg SM, Merino MJ, Rosenberg SA. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998 Jan;16(1):197-203.
PMID:9440743 (Link to Abstract)
O'Sullivan B, Davis AM, Turcotte R, Bell R, Catton C, Chabot P, Wunder J, Kandel R, Goddard K, Sadura A, Pater J, Zee B. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet. 2002 Jun 29;359(9325):2235-41.
PMID:12103287 (Link to Abstract)