[A systematic radio-surgical combination in the treatment of sarcoma of soft tissues in adults. Results in 106 cases at the Centre François Baclesse].

Based on a series of 143 cases of soft tissue sarcomas, including 106 cases treated curatively, the author stresses the importance of surgical resection with frozen section histological control, systematically combined with radiotherapy. Even when resection is complete, the frequency of loco-regional recurrences in all published series shows that neoplastic cells were already present around the resection site. Consequently, since 1972 at the Centre François Baclesse, whenever possible, surgery is preceded by concentrated regional irradiation (2 sessions of 6.50 Gy at 48 hour's interval) and postoperative complementary radiotherapy is always performed regardless of the quality of the resection 3 weeks after the preoperative irradiation. The dose is limited to a total of 50 Gy when the resection is complete and is increased to 60 to 70 Gy in the zones of doubtful or incomplete resection. This postoperative radiotherapy is associated with 5 injections of actinomycin D during the first sessions, but no adjuvant chemotherapy such as cyvadic is administered routinely. Under the conditions of treatment, the 5-year results obtained in 106 cases were as follows: local recurrences: 12.4%, metastases: 26%, survival rate: 76%. When the surgical resection was complete (62 cases), the 5-year local recurrence rate was 1.5% with 9% metastases and 92% survival. Metastases were related to factors of high malignancy which are beginning to be more clearly defined. These forms may benefit from intensive combination chemotherapy.