Postoperative Radiation Therapy in Patients with Extracranial Chondrosarcoma: A Joint Study of the French Sarcoma Group and Rare Cancer Network

Mario Terlizzi, Cécile Le Pechoux, Sébastien Salas, Etienne Rapeaud, Delphine Lerouge, Marie P. Sunyach, Guillaume Vogin, Claudio V. Sole, Thomas Zilli, Myroslav Lutsyk, Ange Mampuya, Felipe A. Calvo, Justine Attal, Vardouhie Karahissarlian, Berardino De Bari, Mahmut Ozsahin, Florian Baumard, Marco Krengli, Anne Gomez-Brouchet, Paul SargosGoulven Rochcongar, Céline Bazille, Vincent Roth, Julia Salleron, Juliette Thariat*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


Purpose: Postoperative radiation therapy (poRT) of intracranial/skull base chondrosarcomas (CHSs) is standard treatment. However, consensus is lacking for poRT in extracranial CHS (eCHS) owing to their easier resectability and intrinsic radioresistance. We assessed the practice and efficacy of poRT in eCHS. Methods and Materials: This multicentric retrospective study of the French Sarcoma Group/Rare Cancer Network included patients with eCHS who were operated on between 1985 and 2015. Inverse propensity score weighting (IPTW) was used to minimize poRT allocation biases. Results: Of 182 patients, 60.4% had bone and 39.6% had soft-tissue eCHS. eCHS were of conventional (31.9%), myxoid (28.6%; 41 extraskeletal, 11 skeletal), mesenchymal (9.9%), or other subtypes. En-bloc surgery with complete resection was performed in 52.6% and poRT in 36.8% of patients (median dose, 54 Gy). Irradiated patients had unfavorable initial characteristics, with higher grade and incomplete resection. Median follow-up time was 61 months. Five-year incidence of local relapse was 10% with poRT versus 21.6% without (P =.050). Using the IPTW method, poRT reduced the local relapse risk (hazard ratio, 0.27; 95% confidence interval, 0.14-0.52; P <.001). Five-year disease-free survival (DFS) was 71.8% with poRT and 64.2% without (P =.680). Using the IPTW method, poRT improved DFS (hazard ratio, 0.51; 95% confidence interval, 0.30-0.85; P =.010). The benefit of poRT on local relapse and DFS was confirmed after exclusion of the extraskeletal subtype. There was no difference in overall survival. Prognostic factors of poorer DFS in multivariate analysis were deeper location, higher grade, incomplete resection, and no poRT. Conclusions: poRT should be offered in patients with eCHS and high-grade or incomplete resection, regardless of the histologic subtype.

Original languageEnglish
Pages (from-to)726-735
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number4
Publication statusPublished - 15 Jul 2020
Externally publishedYes


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