| Objective To evaluate wound complications, local recurrence and survival time ofpreoperative and postoperative radiotherapy for soft tissue sarcomas. Methods Wesearched EMbase, OVID, Highwire, Medline, Cochrane Central register of controlledTrials (The Cochrane Library), CNKI, CBM, collected randomized controlled trials(RCTs), and retrospective studies of preoperative and postoperative radiotherapy for softtissue sarcomas. The quality of the included studies was critically assessed and dataanalyses were performed with the Cochrane Collaboration’s RevMan5.1software.Results Nine studies involving2732patients were included, of which1278were in thepreoperative group, and1458were in the postoperative group. Only1study wasrandomized controlled trial, all the others were retrospective studies. Five eligible studieswere identified including wound complications. The results of meta-analyses showed thatthe preoperative group had higher risk of wound complications than the postoperativegroup with statistic difference [OR=2.43,95%CI (1.17，3.41）, P＜0.00001]. Localrecurrence risk analysis of six studies, the P value for heterogeneity was0.17, and thevariability (I~2) in results across studies due to true differences in treatment effect was35%.The risk for local recurrence was lower in the preoperative group with an odds ratio of0.70,95%CI (0.53-0.92), P=0.01by means of the fixed-effects method. Average survivalwas71.4%(range62-88%) in the preoperative group and58.7%(41-82.8%) in thepostoperative group. Conclusions Compared with the postoperative group, thepreoperative group had higher risk of wound complications for soft tissue sarcomas. Therisk of local recurrence may be lower after preoperative radiation. The findings must beinterpreted with caution because of the heterogeneity and bias in the available studies.Because of the limited quality and quantity of the included studies, more proofs arerequired from more RCTs with large sample. |
PDF Full Text Request