Integration of limb-sparing surgery, brachytherapy, and external-beam

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irradiation in the treatment of soft-tissue sarcomas. OConnor-M-I. Pritchard-D-J. Gunderson-L-L. Section of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida. Clin-Orthop. 1993 Apr. (289). P 73-80. Advances in the integration of limb-sparing surgery and adjuvant radiation therapy have nearly eliminated the need for ablative or radical resections in the management of soft-tissue sarcomas. The combination of wide or marginal surgical resections, brachytherapy, and external-beam irradiation resulted in a local recurrence rate of 9% in 68 patients followed for a minimum of two years. All recurrences were in nonsubcutaneous high-grade lesions. Treatment-related morbidity occurred in 22% of patients. Wound-healing complications developed in 17% and resolved with nonoperative treatment in half. These results support the efficacy of limb-sparing surgery and adjuvant radiation therapy in the management of soft-tissue sarcomas. Integration of chemotherapy may be necessary for the higher-grade lesions, although effectiveness is uncertain. Author-abstract.