{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:54:37Z","timestamp":1776088477320,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,11]],"date-time":"2017-02-11T00:00:00Z","timestamp":1486771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the study was to determine the effect of external beam radiotherapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) in the treatment of extremity soft tissue sarcoma (<jats:styled-content style=\"fixed-case\">STS<\/jats:styled-content>) before or after limb\u2010sparing surgery (<jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content>) in a community\u2010based setting. Patients presenting to our institution from 1992 to 2010 and meeting eligibility criteria were stratified into low (G1) or high (G2, G3) pathologic grade and evaluated. Major complication events, including amputation, radiation\u2010induced sarcoma, and pathologic fracture, were assessed. Kaplan\u2013Meier techniques and Cox proportional hazards regression models were used. One hundred and sixty\u2010two eligible patients underwent <jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content> for extremity <jats:styled-content style=\"fixed-case\">STS<\/jats:styled-content> (120 high grade, 42 low grade). Median time of follow\u2010up was 5.1\u00a0years (0.8\u201320.3\u00a0years). <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> was administered to 111 patients. In unadjusted models, <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> significantly decreased the risk of local recurrence (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>) in high\u2010grade <jats:styled-content style=\"fixed-case\">STS<\/jats:styled-content> patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005) and had a trend for improved recurrence\u2010free survival (<jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.069). In multivariable\u2010adjusted models, <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> significantly improved time to <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), and overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). Analysis of all patients showed those who underwent <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> had a major complication rate (<jats:styled-content style=\"fixed-case\">MCR<\/jats:styled-content>) of 16.2%, compared to 3.9% in the no <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> group (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.037); however, the difference in <jats:styled-content style=\"fixed-case\">MCR<\/jats:styled-content> did not differ significantly when the analysis was restricted to high\u2010grade sarcomas. In our large experience of patients with extremity <jats:styled-content style=\"fixed-case\">STS<\/jats:styled-content> undergoing limb sparing surgery (<jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> significantly improved local recurrence (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>, in patients with high\u2010grade tumors. Efficacy benefits of <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> should be weighed against potential complications. External beam <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> should be considered in patients with resected high\u2010grade sarcomas.<\/jats:p>","DOI":"10.1002\/cam4.972","type":"journal-article","created":{"date-parts":[[2017,2,11]],"date-time":"2017-02-11T05:06:42Z","timestamp":1486789602000},"page":"516-525","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The effect of radiation therapy in the treatment of adult soft tissue sarcomas of the extremities: a long\u2010term community\u2010based cancer center experience"],"prefix":"10.1002","volume":"6","author":[{"given":"Jeffrey S.","family":"Kneisl","sequence":"first","affiliation":[{"name":"Department of Orthopedic Oncology Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Oncology Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myra","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Crimaldi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Will","family":"Ahrens","sequence":"additional","affiliation":[{"name":"Department of Pathology Carolinas Pathology Group  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Symanowski","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Oncology Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Ersek","sequence":"additional","affiliation":[{"name":"Department of Solid Tumor Oncology and Investigational Therapeutics Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Livingston","sequence":"additional","affiliation":[{"name":"Department of Solid Tumor Oncology and Investigational Therapeutics Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Patt","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Oncology Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Solid Tumor Oncology and Investigational Therapeutics Levine Cancer Institute Carolinas HealthCare System  Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,11]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"American Cancer Society.Sarcoma: Adult soft tissue cancer. 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