Hypofractionated adjuvant radiation therapy of soft-tissue sarcoma achieves excellent results in elderly patients

Objective: Adjuvant radiation therapy (RT) is an essential part of combined limb-sparing treatment of soft-tissue sarcoma (STS). Elderly or medically unfit patients often have difficulty in completing 6-7 weeks of standard fractionated daily treatment. Our aim was to evaluate the efficacy of a hypofractionated adjuvant approach with RT for STS in elderly and debilitated patients. Methods: 21 elderly patients were treated with a short course of adjuvant RT (39-48Gy, 3Gy per fraction) for STS. The medical records of the patients were retrospectively reviewed for local or distant recurrence and side effects of RT. Results: At a mean 26 months of follow-up, three local recurrences (14%) were detected. Eight patients (38%) had lung metastases during the observed period. Three of them died from metastatic disease. The hypofractionated radiation was well tolerated with minimum long-term side effects. Conclusion: Hypofractionated adjuvant radiation appears to be an effective treatment in terms of local control in elderly and debilitated patients. Advances in knowledge: The results of this study might provide an alternative to commonly used standard fractionation of radiotherapy in sarcoma patients.