Early outcomes of ultra-hypofractionated preoperative radiation therapy for soft tissue sarcoma followed by immediate surgical resection

Novel Definitive Hypofractionated Accelerated Radiation Dose-painting (HARD) for Unresected Soft Tissue Sarcomas

“…This can be mitigated by a fractionated approach and the use of hypofractionation with isotoxic dose-painting. HFRT has been explored extensively in the neoadjuvant setting, safety of 5, 37 , 38 , 39 , 40 8, 41 , 42 10, 35 , 43 , 44 and 15 fraction 45 regimens before surgery. However, few studies have explored the role of hypofractionated RT for unresectable disease.…”

Modern Multidisciplinary Management of Soft Tissue Sarcoma of the Extremity and Trunk

“…38,39 There are several single-institution studies that have demonstrated the safety and efficacy of hypofractionated radiation of 1-3 weeks total, most commonly 30 Gy in five fractions and 42.5 Gy in 15 fractions. [40][41][42][43][44][45] In a meta-analysis of five-fraction preoperative radiotherapy for STS, which included 208 patients from seven studies, 2-year local control of the entire cohort was 96.9% (95% highest posterior distribution [HPD], 0.9374-0.9889) and the rate of major wound-healing complications was 30.6% (95% HPD, 0.2106-0.4149). 46 These outcomes are comparable with that of historical studies of standard fractionation.…”

2023 Radiation oncology highlights

“…Other published studies have used ultrahypofractionated regimens delivering 25–40 Gy in 5 fractions. Of these, 5 Gy × 5 appears to have lower rates of local control, 6 Gy and 7 Gy × 5 appear to have comparable local control, and 8 Gy × 5 resulted in unacceptable rates of complications 15–20 . These published series differ significantly in dose fractionation, target volumes and dose constraints used, RT delivery (either daily or every other day), timing of surgery following RT, and length of follow up.…”