Post-Surgery Radiation in Sarcoma Cancer Patients May Improve Survival

Study evaluates survival in older patients with soft tissue sarcoma.

Older soft tissue sarcoma (STS) cancer patients saw greater benefits after undergoing radiation therapy post-surgery compared with younger patients.

A study published in Anticancer Research gathered data from the Surveillance, Epidemiology, and End Results (SEER) program, to determine whether radiation after surgery improved disease-specific and overall survival in patients with non-metastatic sarcomas.

After factoring in age and cancer subtypes, researchers found that radiation did increase patient survival compared with surgery alone. Those who would most benefit are patients 65 years and older.

“We found that older patients had a survival benefit with radiation, but in younger patients, many of those benefits went away,” said the study principal investigator Robert Canter. “It seems that older patients respond better to the combination of surgery and radiation.”

Typically STS is treated with surgery, however, it has been unclear whether radiation therapy after surgery actually improves survival.

To find the answer, researchers analyzed data from SEER collected between 1990 and 2011. There were 15,380 non-pediatric patients with non-metastatic STS identified, who were treated with only surgery or with radiation and surgery.

The results of the study were somewhat surprising to researchers, revealing significant improvements in overall survival and disease-specific survival in older patients across majority of sarcomas — especially 12 major subtypes that included rhabdomyosarcoma, fibrosarcoma, and synovial sarcoma. Younger patients saw much less benefit from the radiation therapy.

“We were thinking it would be the opposite,” Canter said. “If the benefit is immune-mediated, younger patients should respond better since they have stronger immune systems.”

Although younger patients did not see the same level of benefit from radiation, they still saw better overall and disease-specific survival from STS.

While these findings show promise, investigators said that further research needs to confirm the results and determine the mechanisms that drive these age-related radiotherapy benefits.

“We sometimes don't want to treat older people with radiation because we're worried about the side effects,” Canter said. “However, these results indicate these patients should really be receiving it if they are candidates.”