Use of intraoperative electron beam radiotherapy in the management of retroperitoneal soft tissue sarcomas

Petersen, Ivy A.; Haddock, Michael G.; Donohue, John H.; Nagorney, David M.; Grill, Joseph P.; Sargent, Daniel J.; Gunderson, Leonard L.

doi:10.1016/s0360-3016(01)02595-0

Cited by 170 publications

(101 citation statements)

References 15 publications

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“…In this regard, there are ongoing trials of preoperative radiation associated with a perioperative (intraoperative or postoperative) boost. [11][12][13][14][15][16][17][18][19][20] This novel approach is interesting, but it remains experimental. With re- gard to adjuvant chemotherapy, recent data point to its possible benefit in the treatment of adult STS, provided full doses are employed and high-risk patients are selected: 22,23 If so, then patients with highgrade nonliposarcomas may benefit from chemotherapy for distant metastases.…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal soft tissue sarcomas

Gronchi

Casali

Fiore

et al. 2004

Cancer

160

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BACKGROUNDThe objective of this study was to assess long‐term prognosis and patterns of failure in patients with retroperitoneal soft tissue sarcoma who underwent surgery with curative intent at a single institution. Several series of patients with retroperitoneal sarcoma were reported, providing widely variable data regarding local and distant failure.METHODSOverall, 167 consecutive patients who underwent surgery for retroperitoneal soft tissue sarcoma over a 20 year span at a single referral center were reviewed retrospectively. Eighty‐two patients presented with primary disease, whereas 85 patients had recurrent locoregional tumors. Surgical resection was considered macroscopically complete in 147 of 167 patients (88%).RESULTSOverall survival at 10 years after definitive surgery was approximately 27%, and the disease‐free survival was approximately 16%. Only a minority of patients developed distant metastases. The risk of recurrence was correlated with whether patients underwent surgery for primary disease or for recurrent disease; the 10 year disease‐free survival rate was 27% in the former group and 4.6% in the latter group. Histotype and malignancy grade were other prognostic factors, with the former found to be predictive of the pattern of failure and the latter predictive of overall survival.CONCLUSIONSLocal recurrence after primary surgery and high‐grade malignancy were associated with the worst survival. Histologic subtype appeared to influence the pattern of recurrence, which mainly was local for patients with liposarcoma but was both local and distant for patients with the other histotypes. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

“…Indeed, the approach to retroperitoneal STS is under active investigation. Novel radiation therapy techniques have been explored, [11][12][13][14][15][16][17][18][19][20][21] and the role of adjuvant chemotherapy still is debated. 22,23 However, efforts to improve treatment results should be based on the patterns in which these tumors currently fail.…”

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confidence: 99%

Retroperitoneal soft tissue sarcomas

Gronchi

Casali

Fiore

et al. 2004

Cancer

160

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“…It is noteworthy that the reported 5-year LCR was 69% compared with 59% in a previous publication from those authors. 17 For the 26 patients who completed IOERT (15 Gy) and EBRT (45 Gy) after R0 resection at Heidelberg, the 5-year and 10-year OS rates were both 80%, and the 5-year and 10-year LCR was as high as 100%. The only factor that had a significant impact on OS was resection status, with an almost 40% advantage observed among patients who underwent R0 resection (5-year OS: 87% [R0] vs 50% [R1/R2]).…”

Section: Ioertmentioning

confidence: 96%

“…Ten patients received chemotherapy. 17 An update of the work by Petersen Ballo et al reported on 83 patients (60 patients with primary disease and 23 patients with recurrent disease) who received EBRT (n ¼ 63), EBRT with IOERT (n ¼ 18), EBRT with a perioperative brachytherapy boost (n ¼ 1), and brachytherapy alone (n ¼ 1) after R0/R1 resection. The median IORT dose was 15 Gy.…”

Section: Iort Alone or Combined Withmentioning

confidence: 99%

“…8,[10][11][12][13] After undergoing macroscopically complete surgery alone, local recurrences develop in 20% to 75% of patients, and these can occur even after 5 years of follow-up. 1,8,10,[14][15][16][17][18][19] The estimated survival rate at 5 years varies between 12% and 75%, 6,13,20,21 and the cause of death for these patients usually is local recurrence, which is in sharp contrast to outcomes for patients with sarcoma of the extremities. 8,22 There is much controversy concerning the role of radiotherapy (RT) in the treatment of RSTS.…”

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confidence: 99%

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Radiotherapy and surgery—An indispensable duo in the treatment of retroperitoneal sarcoma

Voorde

Delrue

Eijkeren

et al. 2011

Cancer

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The authors undertook a systematic review to designate the role that radiotherapy (RT) might play in the treatment of retroperitoneal sarcomas. Correlating with recent literature, the objective of this review was to evaluate whether there was enough evidence for the authors to develop an institutional treatment protocol concerning the use of RT in the treatment of retroperitoneal sarcoma. Furthermore, this was a call for surgeons to talk to radiation oncologists before performing surgery. The 2 objectives of this review were: 1) to determine the benefit of RT in terms of local control and/or survival in the treatment of retroperitoneal sarcomas and 2) to discover the optimal timing of RT in the treatment sequence. A computerized literature search was performed in the PubMed database, the Cochrane Library database, and reference lists; and journals also were searched by hand to identify all retrospective and prospective reports published since 1998 relating to RT treatment of adult retroperitoneal sarcoma. Mainly, analyses were sought that were based on a 5-year local control rate (LCR), 5-year disease-free survival, and 5-year overall survival (OS). If only 2 years follow-up were available, then the authors also noted this outcome. Toxicity data were collected and analyzed separately. The synthesis of the literature was based on 9 prospectively nonrandomized studies and 10 retrospective studies that, together, reviewed a total of 1426 patients. The 5-year LCR varied from 27% to 62%, and the results from other reports fell in between those values. The 5-year OS rate ranged from 12% to 90%, and complete resection and tumor grade were the most important prognostic factors in most studies. This review resulted in 7 recommendations concerning the use of RT in the treatment of retroperitoneal sarcoma. The authors concluded that there is good evidence from multiple single-institutions studies that RT improves the LCR in patients with retroperitoneal sarcoma. Until now, there has not been a translation of this approach into survival benefit. The current results indicated that preoperative external-beam RT followed by radical surgery seems to be the preferred sequence, and adding intraoperative RT is a safe procedure for dose escalation in the upper abdomen. Cancer 2011;117:4355-

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Soft Tissue Sarcomas

Maki

Raut

O’Sullivan

2017

Holland‐Frei Cancer Medicine

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Overview The management of soft tissue sarcomas is driven by the anatomic site and histology of the primary and is increasingly affected by the specific genetics of the sarcoma. In this chapter, we focus on the principles of management of this group of over 50 cancer subtypes to highlight commonalities and differences from anatomical constraints of surgery to specifics of adjuvant radiation to identification of systemic therapeutics that are appropriate for each histology. We will discuss in this chapter the etiology, presentation, diagnosis, staging, and multidisciplinary management of patients with sarcomas of soft tissue. Surgery remains paramount to achieve cure for the vast majority of sarcomas. Radiation therapy is used for larger tumors in the appropriate clinical context. The evolution of increasingly sophisticated radiation techniques is highlighted in this chapter. As pertains to systemic therapy, this chapter is written at a time in which first‐line therapies for soft tissue sarcomas may change, raising anew some questions of adjuvant therapy that remain incompletely answered. Where appropriate, we attempt to link specific histologies or molecular changes to therapeutic suggestions, with the understanding and hope that novel agents will supplant the medications that are available but that have not materially affected outcomes for few diagnoses other than GIST in the past several years.

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Use of intraoperative electron beam radiotherapy in the management of retroperitoneal soft tissue sarcomas

Cited by 170 publications

References 15 publications

Retroperitoneal soft tissue sarcomas

Retroperitoneal soft tissue sarcomas

Radiotherapy and surgery—An indispensable duo in the treatment of retroperitoneal sarcoma

Soft Tissue Sarcomas

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