Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial

Bonvalot, Sylvie; Gronchi, Alessandro; Péchoux, C. Le; Swallow, Carol J.; Strauß, D.; Méeus, Pierre; Coevorden, Frits van; Stoldt, Stephan; Stoeckle, Eberhard; Rutkowski, Piotr; Rastrelli, Marco; Raut, Chandrajit P.; Hompes, Daphne; Paoli, Antonino De; Sangalli, Claudia; Honoré, Charles; Chung, Peter; Miah, Aisha; Blay, Jean Yves; Fiore, Marco; Stelmes, Jean-Jacques; Tos, Angelo Paolo Dei; Baldini, Elizabeth H.; Litière, Saskia; Marréaud, Sandrine; Gelderblom, Hans; Haas, Rick L.

doi:10.1016/s1470-2045(20)30446-0

Cited by 323 publications

(229 citation statements)

References 32 publications

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“…As suggested from retrospective data, addition of neoadjuvant RT did not result in distinctly increased rates of severe side effects or major postoperative complications and did not significantly impact overall survival (3y-OS 85% vs. 84%) [30]. Surprisingly, the study also failed to show a benefit for neoadjuvant RT regarding the primary endpoint (3y-abdominal-recurrence free survival, ARFS) [30]. An event within ARFS was defined as either a true local recurrence after macroscopic complete resection, diagnosis of peritoneal sarcomatosis at laparotomy, macroscopic incomplete resection, local or distant progression according to RECIST criteria during radiation therapy, or a lesion becoming "inoperable" between randomization and surgery [30].…”

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 71%

“…Surprisingly, the study also failed to show a benefit for neoadjuvant RT regarding the primary endpoint (3y-abdominal-recurrence free survival, ARFS) [30]. An event within ARFS was defined as either a true local recurrence after macroscopic complete resection, diagnosis of peritoneal sarcomatosis at laparotomy, macroscopic incomplete resection, local or distant progression according to RECIST criteria during radiation therapy, or a lesion becoming "inoperable" between randomization and surgery [30]. Subgrouping of the events in both arms revealed that the majority of events in the surgical only arm were true local recurrences after macroscopic complete resection (64%), while this was the case only for a minority of patients in the combined treatment arm (28%) [30].…”

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 93%

“…This prompted the investigators to perform two sensitivity analyses, excluding local progression during RT in the first, and local progression during RT or becoming medically unfit for surgery in the second, as an event in patients who achieved a macroscopic complete resection. This resulted in (non-significant) absolute 3-y-ARFS benefits of 7.3% in the first and 9.1% in the second analysis, favouring the combined treatment arm [30]. Further subgroup analyses revealed large differences based on histological subtype and grading.…”

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 95%

“…Recently, the results of the randomized STRASS trial were published [30], which evaluated the value of neoadjuvant RT compared to surgery alone in 266 patients. As suggested from retrospective data, addition of neoadjuvant RT did not result in distinctly increased rates of severe side effects or major postoperative complications and did not significantly impact overall survival (3y-OS 85% vs. 84%) [30]. Surprisingly, the study also failed to show a benefit for neoadjuvant RT regarding the primary endpoint (3y-abdominal-recurrence free survival, ARFS) [30].…”

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 99%

“…An event within ARFS was defined as either a true local recurrence after macroscopic complete resection, diagnosis of peritoneal sarcomatosis at laparotomy, macroscopic incomplete resection, local or distant progression according to RECIST criteria during radiation therapy, or a lesion becoming "inoperable" between randomization and surgery [30]. Subgrouping of the events in both arms revealed that the majority of events in the surgical only arm were true local recurrences after macroscopic complete resection (64%), while this was the case only for a minority of patients in the combined treatment arm (28%) [30]. The most common event within the combined arm was progression during radiotherapy according to RECIST criteria, although the value of RECIST criteria for response evaluation of STS after radiation or chemotherapy is highly controversial [31].…”

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 99%

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Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

Roeder

2020

Cancers

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Radiation therapy (RT) is an integral part of the treatment of adult soft-tissue sarcomas (STS). Although mainly used as perioperative therapy to increase local control in resectable STS with high risk features, it also plays an increasing role in the treatment of non-resectable primary tumors, oligometastatic situations, or for palliation. Modern radiation techniques, like intensity-modulated, image-guided, or stereotactic body RT, as well as special applications like intraoperative RT, brachytherapy, or particle therapy, have widened the therapeutic window allowing either dose escalation with improved efficacy or reduction of side effects with improved functional outcome. This review summarizes the current evidence for RT in adult STS including typical indications, outcomes, side effects, dose and fractionation regimens, and target volume definitions based on tumor localization and risk factors. It covers the different overall treatment approaches including RT either as part of a multimodal treatment strategy or as a sole treatment, namely its use as an adjunct to surgery in resectable STS (perioperative RT), as a primary treatment in non-resectable tumors (definitive RT), as a local treatment modality in oligometastatic disease or as palliative therapy. Due to the known differences in clinical course, general treatment options and, consequently, outcome depending on lesion localization, the main part of perioperative RT is divided into three sections according to body site (extremity/trunk wall, retroperitoneal, and head and neck STS) including the discussion of special applications of radiation techniques specifically amenable to this region. The review of the current evidence is accompanied by a summary on ongoing clinical research pointing at future directions of RT in STS.

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Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 71%

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 93%

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 95%

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 99%

Section: Perioperative Rt In Retroperitoneal Sarcomasmentioning

confidence: 99%

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Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

Roeder

2020

Cancers

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Unilateral Leg Swelling in a Young Woman

Lambden

Didwania

2021

JAMA Oncol

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A 33-year-old woman with a history of hereditary bilateral retinoblastoma as an infant presented to a primary care clinic with 1 week of right lower extremity swelling. At age 8 months, she was treated with right enucleation and left eye radiotherapy (50.4 Gy). At age 4 years, she developed a recurrence of the retinoblastoma in the nasal cavity and was treated with 4 cycles of vincristine, doxorubicin, and cyclophosphamide followed by 1 cycle of cisplatin, etoposide, and intrathecal cytarabine.Primary care evaluation was prompted by her mother, as the patient had not noticed her lower extremity edema. She had no fevers, weight loss, shortness of breath, chest pain, abdominal pain, or history of deep vein thrombosis. Her physical examination was notable for firm, nonpitting edema to the hip. She did not have any associated tenderness, inguinal lymphadenopathy, or palpable abdominal masses. Her vital signs were within normal limits and she ambulated comfortably. Laboratory work results, including a complete blood cell count with a differential, comprehensive metabolic panel, and D-dimer levels, were within normal limits. Doppler ultrasonography of her right lower extremity showed no deep vein thrombosis. A computed tomography venogram demonstrated a 4.0 × 3.5 cm mass of likely vascular origin that was extending into the right common iliac vein (Figure).

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Harnessing Bacterial Membrane Components for Tumor Vaccines: Strategies and Perspectives

Bai,

Wang,

Liang

et al. 2024

Adv Healthcare Materials

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Tumor vaccines stand at the vanguard of tumor immunotherapy, demonstrating significant potential and promise in recent years. While tumor vaccines have achieved breakthroughs in the treatment of cancer, they still encounter numerous challenges, including improving the immunogenicity of vaccines and expanding the scope of vaccine application. As natural immune activators, bacterial components offer inherent advantages in tumor vaccines. Bacterial membrane components, with their safer profile, easy extraction, purification, and engineering, along with their diverse array of immune components, activate the immune system and improve tumor vaccine efficacy. This review systematically summarizes the mechanism of action and therapeutic effects of bacterial membranes and its derivatives (including bacterial membrane vesicles and hybrid membrane biomaterials) in tumor vaccines. Subsequently, the authors delve into the preparation and advantages of tumor vaccines based on bacterial membranes and hybrid membrane biomaterials. Following this, the immune effects of tumor vaccines based on bacterial outer membrane vesicles are elucidated, and their mechanisms are explained. Moreover, their advantages in tumor combination therapy are analyzed. Last, the challenges and trends in this field are discussed. This comprehensive analysis aims to offer a more informed reference and scientific foundation for the design and implementation of bacterial membrane‐based tumor vaccines.

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Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial

Cited by 323 publications

References 32 publications

Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

Unilateral Leg Swelling in a Young Woman

Harnessing Bacterial Membrane Components for Tumor Vaccines: Strategies and Perspectives

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