Contemporary radiotherapy for soft tissue sarcoma

Wylie, James; O’Sullivan, Brian; Catton, Charles; Gutierrez, Eric

doi:10.1002/(sici)1098-2388(199907/08)17:1<33::aid-ssu5>3.0.co;2-n

Cited by 21 publications

(3 citation statements)

References 79 publications

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“…Given the high incidence of LR with surgery alone, rare regional lymphatic involvement, and a propensity for pulmonary metastases, the clinical behavior of DM appears to be similar to soft tissue sarcomas rather than other cutaneous melanomas 7, 16, 17. With retrospective studies of adjuvant hypofractionated radiation therapy (RT) demonstrating a benefit in locoregional control in high‐risk non‐DM patients versus historical controls, as well as anecdotal and retrospective reports of good clinical results in high‐risk DM patients, a prospective phase II study was designed to determine if adjuvant hypofractionated RT would result in low LR rates in selected DM patients 9, 18, 19, 20, 21, 22, 23, 24, 25.…”

Section: Introductionmentioning

confidence: 99%

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

et al. 2016

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To examine, in a prospective fashion, the utilization and efficacy of adjuvant radiation therapy (RT) in patients with resected desmoplastic melanoma (DM). Adult patients with resected, margin‐negative, and nonmetastatic DM were eligible for this single‐arm prospective phase II study. Patients were to receive postoperative RT, 30 Gy in five fractions, to the operative bed with 2‐ to 3‐cm margins (depending on the tumor location). Nodal basin RT was not allowed. The primary study endpoint was the 2‐year local recurrence rate (LRR). Secondary endpoints included the incidence of regional and distant metastatic disease, progression‐free survival, overall survival (OS), and treatment‐related toxicity. Twenty patients with a single de novo DM lesion meeting trial eligibility criteria were enrolled and treated. The 2‐year LRR was 10%, with two patients demonstrating a LR within 2 years of completion of protocol therapy. No regional or distant failures occurred. OS at 2 and 5 years was 95 and 77%, respectively. There were no grade 3 or higher acute or late adverse events that were related to the protocol therapy. Adjuvant RT after wide local excision (WLE) for DM is efficacious and well tolerated. It should be considered for DM patients after margin‐negative WLE. Additional study is needed to further refine low‐risk patient populations that can potentially have adjuvant RT omitted as part of the treatment plan.

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Section: Introductionmentioning

confidence: 99%

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

et al. 2016

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“…High-dose radiation therapy has previously been reported to elicit a response from ESMC, while adjuvant chemotherapy has been reported to elicit only a poor response ( 26 ). Radiation therapy is recommended for high-grade sarcomas, moderately-differentiated tumors, positive surgical margins and recurrent sarcoma ( 27 – 29 ). The two drugs with the highest established response rates in soft-tissue sarcoma are doxorubicin and ifosfamide, and this drug combination has been used as the gold standard for a number of years.…”

Section: Introductionmentioning

confidence: 99%

Extraskeletal myxoid chondrosarcoma of the vulva: A case report

Виллерт¹,

Kolomiets²,

Vasilyev³

et al. 2015

Oncology Letters

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Extraskeletal myxoid chondrosarcoma (ESMC) of the vulva is an extremely rare tumor and currently, there is little available information on its biological behavior and treatment strategy. The present study reports a case of recurrent ESMC of the vulva in a 32-year-old female. The patient presented with an increasingly painful mass of the right vulva, at the site of an exision which had been performed 7-months previously. The tumor mass was histopathologically diagnosed as primary ESMC of the vulva and subsequently, vulvectomy was performed. Cytological examination showed negative surgical margins. Intraoperative radiation therapy at a single dose of 10 Gy was administered to the bed of the removed tumor. The patient refused chemotherapy and five months after surgery, a new lesion was identified in the inguinal region. Bilateral inguinal-femoral lymph node dissection was performed and external beam radiation therapy at a dose of 40 Gy was administered to the inguinal region. Follow-up examination seven months after surgery revealed no evidence of disease progression and at present, the patient remains alive. This study highlights the importance of analyzing each clinical case of ESMC as this may lead to the development of guidelines for the optimal treatment of this rare tumor.

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“…The addition of radiation to surgery has resulted in 90% local control at 10 years [8], but this has not correlated to an improvement in the incidence of distant metastases or survival.…”

Section: Opinion Statementmentioning

confidence: 99%

Adjuvant therapy for extremity sarcomas

Schlieman

Smith²,

Kraybill

2006

Curr. Treat. Options in Oncol.

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Extremity soft tissue sarcomas (STS) represent a rare, heterogeneous malignancy. Surgery is the primary treatment for patients with no evidence of metastatic disease, and for small low-grade superficial tumors in which adequate margins can be obtained, it may be the only therapy indicated. For large, deep tumors or tumors that are close to important neurovascular structures or bone, the addition of radiotherapy to resection has improved local control and increased limb salvage without affecting overall survival. Adjuvant chemotherapy has been an issue of considerable debate. Because 50% of patients with high-risk tumors will develop metastatic disease, effective systemic treatment with chemotherapy is needed. Unfortunately, studies have shown minimal improvement in overall survival when chemotherapy is added to the local treatment of high-risk extremity STS. More recently, a few trials of neoadjuvant chemotherapy consisting of mesna, doxorubicin, ifosfamide, and dacarbazine and high-dose doxorubicin and ifosfamide have shown some early promising results, but at the price of increased toxicity. Targeted therapy has shown some of its best results with gastrointestinal stromal tumors, but so far there has been little success in treating extremity STS. At this time, high-dose adjuvant or neoadjuvant chemotherapy should be given in the setting of a clinical trial to patients with high-risk tumors who can tolerate a potentially toxic chemotherapeutic regimen. The goal of these trials should be to assess new combination therapies, possibly including targeted therapies, for the management of large high-grade, high-risk soft tissue sarcomas.

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Contemporary radiotherapy for soft tissue sarcoma

Cited by 21 publications

References 79 publications

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

Extraskeletal myxoid chondrosarcoma of the vulva: A case report

Adjuvant therapy for extremity sarcomas

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