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. 2024 Sep-Oct;14(5):e373-e382.
doi: 10.1016/j.prro.2024.05.006. Epub 2024 Jun 6.

Outcomes for Patients With Head and Neck Sarcoma Treated Curatively With Radiation Therapy and Surgery

Alison K Yoder  1 , Ahsan Farooqi  2 , Devarati Mitra  1 , J Andrew Livingston  3 , Dejka M Araujo  3 , Erich M Sturgis  4 , Ryan Goepfert  5 , Andrew J Bishop  1 , B Ashleigh Guadagnolo  1
Affiliations

Outcomes for Patients With Head and Neck Sarcoma Treated Curatively With Radiation Therapy and Surgery

Alison K Yoder et al. Pract Radiat Oncol. 2024 Sep-Oct.

Abstract

Purpose: Soft tissue sarcomas (STSs) of the head and neck (H&N) are rare malignancies that are challenging to manage. We sought to describe the outcomes of patients treated with curative intent using combined surgery and radiation therapy (RT) for H&N STS.

Methods and materials: We performed a single-institution retrospective review of patients with nonmetastatic STS of the H&N who were treated from 1968 to 2020. The Kaplan-Meier method was used to estimate disease-specific survival (DSS) and local control (LC). Multivariable analyses (MVAs) were conducted using Cox proportional hazards model.

Results: One hundred ninety-two patients had a median follow-up of 82 months. Tumors arose in the neck (n = 50, 26%), paranasal sinuses (n = 36, 19%), or face (n = 23, 12%). Most patients were treated with postoperative RT (n = 134, 70%). Postoperative RT doses were higher (median, 60 Gy; preoperative dose, 50 Gy; P < .001). Treatment sequence was not associated with LC (preoperative RT, 78% [63%-88%]; postoperative RT, 75% [66%-82%]; P = .48). On MVA, positive/uncertain margin was the only variable associated with LC (hazard ratio [HR], 2.54; 95% CI, 1.34-4.82; P = .004). LC was significant on MVA (HR, 4.48; 95% CI, 2.62-7.67; P < .001) for DSS. Patients who received postoperative RT were less likely to experience a major wound complication (7.5% vs 22.4%; HR, 0.28; 95% CI, 0.11-0.68; P = .005). There was no difference in the rate of late toxicities between patients who received preoperative or postoperative RT.

Conclusions: H&N STS continues to have relatively poorer LC than STS of the trunk or extremities. We found LC to be associated with DSS. Timing of RT did not impact oncologic or long-term toxicity outcomes; however, preoperative RT did increase the chance of developing a major wound complication.

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Conflict of interest statement

Conflicts of Interest: None of the authors have any conflicts of interest to report

Figures

Figure 1.
Figure 1.
Local control, disease-specific survival, disease-free survival, and distant metastasis–free survival of patients treated with surgery and preoperative or postoperative radiation therapy.
See this image and copyright information in PMC

References

    1. Stiller CA, Trama A, Serraino D, Rossi S, Navarro C, Chirlaque MD, et al. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer. 2013;49(3):684–95. - PubMed
    1. DeVita VT, Lawrence TS, Rosenberg SA. Cancer of the Breast: From Cancer: Principles & Practice of Oncology: Lippincott Williams & Wilkins; 2016.
    1. Gorsky M, Epstein JB. Head and neck and intra-oral soft tissue sarcomas. Oral Oncol 1998;34(4):292–6. - PubMed
    1. Mücke T, Mitchell DA, Tannapfel A, Hölzle F, Kesting MR, Wolff KD, et al. Outcome in adult patients with head and neck sarcomas - A 10-year analysis. Journal of Surgical Oncology. 2010;102(2):170–4. - PubMed
    1. de Bree R, van der Waal I, de Bree E, René Leemans C. Management of adult soft tissue sarcomas of the head and neck. Oral Oncology. 2010;46(11):786–90. - PubMed