The histologic response of soft tissue XXXX to radiation therapy.

@entity1 @entity5 @entity242 @entity39
Twenty-seven @entity1 with soft tissue @entity242 had preoperative radiotherapy, limb-sparing marginal surgical resection and whole-mount @entity5 histologic analysis. Incisional biopsy specimens before radiotherapy were reviewed for @entity5 type, grade, and extent of @entity39 . Preoperative radiotherapy was given in either of two regimens: 13 @entity1 received a mean total dose of 5250 cGy in one daily 180 to 200 cGy fractions and 14 @entity1 a mean total dose of 4770 cGy in two daily fractions of 180 to 200 cGy separated by 4 hours. Twenty-one specimens had at least 80% @entity39 or severely altered cells, a 3+ to 4+ response. Grade and size of the @entity5 appeared to be indicators of response to treatment rather than histologic type. Three of five @entity1 (60%) with Grade 1, eight of 11 @entity1 (73%) with Grade 2 lesions, and ten of 11 @entity1 (91%) with Grade 3 @entity5 had 80% or greater @entity39 or severely altered cells. For @entity5 10 cm or less in greatest diameter, the 3+ to 4+ histologic response was seen in 12 of 14 @entity1 (86%) whereas for lesions greater than 10 cm, this response was observed in nine of 13 @entity1 (69%). For @entity1 with Grade 2 or 3 soft tissue @entity242 , 13 of 14 @entity1 (93%) treated with two fractions per day and two of four @entity1 (50%) receiving one fraction per day exhibited significant response. All six @entity1 treated twice daily for lesions greater than 10 cm had 3+ to 4+ histologic response compared to three of seven (43%) @entity1 treated once per day. Therefore, grade and size of soft tissue @entity242 are important predictors of response to radiotherapy and preoperative twice daily radiotherapy may more likely permit the conservative surgical excision of @entity242 of borderline resectability.
