Radiation modalities linked with fewer wound complications in patients with soft tissue sarcoma

SAN DIEGO — Patients with soft tissue sarcoma who underwent radiation modalities, such as proton therapy and intensity-modulated radiotherapy, experienced fewer wound complications compared with patients who underwent 3-D conformal techniques, according to results presented here.

“Our study demonstrates that both radiation modality and radiation dermatitis may be predictors of wound complications in this population,” Drake Lebrun, BS, said here at the American Academy of Orthopaedic Surgeons Annual Meeting.

Brake Lebrun

Lebrun and colleagues performed a retrospective review of 67 patients with soft tissue sarcomas who underwent resection and radiation therapy. Primary outcome measures included major wound complications and any wound complication, defined as the development of a major or minor wound complication. Researchers assessed whether seven radiation parameters were associated with a differential risk of developing wound complications and compared the use of 3-D conformal radiation with the use of intensity-modulated radiotherapy or proton radiation.

Results showed a total of 22 any wounds, comprised of 14 major wounds and eight minor wounds.

“On univariate analysis, we found that only diabetes was associated with an increased risk of major wound complications,” Lebrun said. “When we looked at any wound complication, we found that diabetes, the use of vascularized flaps for skin grafts and a presence of grade 2 or higher radiation dermatitis were all associated with an increased risk of any wounds.”

Lebrun noted a decreased risk of any wounds with the use of intensity-modulated radiotherapy or proton radiation vs. 3-D conformal radiation therapy. Diabetes and grade 2 or higher of radiation dermatitis remained significantly associated with an increased risk of any wounds, according to multivariable logistic regression. Lebrun also noted the use of intensity-modulated radiotherapy or proton radiation remained significantly associated with a decreased risk of any wounds in multivariable analysis vs. 3-D conformal radiation. – by Casey Tingle

Reference:

Guttmann D, et al. Paper #72. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.

Disclosure: Lebrun reports no relevant financial disclosures.