Feasibility of preoperative dose-painting intensity modulated radiation therapy (IMRT) for borderline-resectable primary retroperitoneal sarcoma Journal Article
| Authors: | Zhang, M.; Crago, A.; Yoon, S. S.; Singer, S.; Alektiar, K. |
| Article Title: | Feasibility of preoperative dose-painting intensity modulated radiation therapy (IMRT) for borderline-resectable primary retroperitoneal sarcoma |
| Abstract: | Purpose: The role of radiation therapy (RT) in resectable retroperitoneal sarcoma (RPS) remains controversial; however, preoperative RT may play an important role in borderline-resectable (at risk of R2 resection) disease. We evaluated the outcome of such patients treated with preoperative dose-painting IMRT followed by planned resection. Methods: Between January 2001 and December 2017, 30 patients with borderline-resectable primary nonmetastatic RPS (after multidisciplinary review) received preoperative dose-painting IMRT in this retrospective cohort study. Results: Median follow-up for all patients was 32 months. Median dose to the whole tumor/high-risk margin was 50.4 Gy/60.2 Gy. Sixteen patients were female, 24 were >50 years. Median tumor size was 9.2 cm. After RT, 6 did not have surgery. Of the 24 who were explored, 20 underwent complete gross resection. During RT, 7 of 30 patients developed acute grade 2+ toxicities: 5 fatigue, 1 nausea and vomiting, and 1 cystitis. RT was completed in 29 of 30 patients. Postoperatively, 12 of 20 patients developed grade 2+ complications: 2 gastropathy, 5 intraabdominal collections requiring drainage, 1 retroperitoneal bleed, and 3 delayed wound healing. Late grade 2+ toxicity was observed in 3 of 20 patients: 1 lymphedema with recurrent cellulitis, 1 chronic diarrhea, 1 gastrointestinal bleeding from anastomosis requiring transfusions, and 2 renal insufficiency. In those who underwent complete gross resection (n = 20, median follow-up 47 months), the 5-year local control was 57%, and overall survival was 46%. Discussion: Preoperative dose-painting IMRT given to borderline-resectable RPS rendered 67% of patients resectable, provided a 5-year local control rate of 57%, which is similar to those with resectable disease, and had an acceptable morbidity profile. © 2022, Society of Surgical Oncology. |
| Keywords: | retrospective studies; intensity modulated radiation therapy; pathology; retrospective study; sarcoma; feasibility study; feasibility studies; radiotherapy, intensity-modulated; retroperitoneal tumor; retroperitoneal neoplasms; soft tissue neoplasms; soft tissue tumor; adverse event; humans; human; male; female |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 29 |
| Issue: | 11 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2022-10-01 |
| Start Page: | 7115 |
| End Page: | 7121 |
| Language: | English |
| DOI: | 10.1245/s10434-022-12053-7 |
| PUBMED: | 35771370 |
| PROVIDER: | scopus |
| PMCID: | PMC10367943 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 October 2022 -- Source: Scopus |
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