Age may be a significant determinant of the effectiveness of radiotherapy in patients with soft-tissue sarcoma undergoing surgery, according to a recent study.
While the survival rates for early-stage, soft-tissue sarcoma are generally high, studies have shown that older patients with the disease typically have more difficulty surviving 5 years, due in large part to the fact that they often present with worse tumors and are treated less aggressively. However, some treatment methods still have the potential to benefit older patients without causing significant harm.
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Based on the immune-mediated mechanisms of radiotherapy, researchers led by Noah Yuen, MD, UC Davis School of Medicine (Sacramento, CA), hypothesized that older patients might benefit more from radiotherapy plus surgery versus surgery alone.
To test that theory, they used Surveillance, Epidemiology, and End Results (SEER) Program data to identify 15,380 patients diagnosed with non-metastatic soft-tissue sarcoma between 1990 and 2011, stratifying them based on age and histological subtype. They then assessed different predictors of overall and disease-specific survival.
Researchers observed that both overall and disease-specific survival were longer in patients who received treatment that included radiotherapy rather than surgery alone. Also, multivariate analysis revealed that age was indeed a significant factor in patients’ response to radiotherapy. Older patients demonstrated significantly improved overall and disease-specific survival while younger patients did not. In addition, older patients with leiomyosarcoma, myxoid liposarcoma, and sarcoma not otherwise specified also had better outcomes than younger patients with these diagnoses.
Further computational analysis suggested that the year of diagnosis could have an impact on outcomes associated with radiotherapy treatment, but no such data was observed relating the date of treatment initiation, indicating that the early identification of symptoms may be a vital component of enhancing care.
The researchers concluded that the results confirmed their initial hypothesis of age being a key predictor of oncological outcomes after radiotherapy.
