Meta Analysis Of Excresectable Soft Tissue Sarcomas Compared With Preoperative And Postoperative Radiotherapy

Objective:The goal of this study was to evaluate the role of preoperative and postoperative radiotherapy in the treatment of soft tissue sarcoma(STS)in different parts.Methods:A systematic literature search was conducted to investigate the effects of preoperative and postoperative radiotherapy on local recurrence(LR),progression free survival(PFS),total survival(OS),postoperative complications(WC)and distant metastasis(DM)after STS.The ratio Ratio(OR)is expressed by the Metaanalysis of the fixed effect model.Results:A total of 14 clinical studies(n=2760)were used to compare the role of preoperative and postoperative radiotherapy,including a randomized controlled trial(RCT).Metaanalysis showed that preoperative radiotherapy reduced LR in the retroperitoneal soft tissue sarcoma(OR=0.22,95% CI [0.08,0.61],P=0.003),and LR in the extremities,trunk and head and neck soft tissue sarcoma(OR=0.63,95% CI [0.48,CI,=0.001).Preoperative radiotherapy significantly increased WC wound complications of soft tissue sarcoma of the extremities after surgery(OR=2.41,95% CI [1.85,3.13],P <0.00001);improve the limbs,torso and head and neck soft tissue sarcoma PFS(OR=-0.07,CI 95% [-0.14,-0.00],P=0.04)and increased DM(OR=1.41 CI,95% [1.11,1.79],P=0.005),but there were no significant changes in the retroperitoneal soft tissue sarcoma.Preoperative radiotherapy showed significant difference in OS(OR=1,95% CI [0.83,1.20],P=1)in retroperitoneal soft tissue sarcoma,while OS(OR=0.80,95% CI[0.63,1.01],P=0.06)in limbs,trunk and head and neck soft tissue sarcoma was not statistically significant.Conclusions:The Meta analysis of 14 clinical trials showed that preoperative radiotherapy could effectively reduce the local recurrence rate of STS in the limbs,trunk,head and neck and retroperitoneal resection of STS,and could reduce the risk of distant metastasis of STS in the limbs,trunk and head and neck.Postoperative radiotherapy can increase the STS progression free survival time of limbs,trunk and head and neck,and reduce the risk of STS wounds in limbs,torso and head and neck.