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Preoperative radiotherapy soft tissue sarcoma

Rick L Haas, Suzanne van Beek, Anja Betgen, Shaheen Ali, Christoph J Schneider, Fenna Heres Diddens, Astrid N Scholten, Folkert Koetsveld, Peter Remeijer
PURPOSE: Many authors suggest that extremity soft tissue sarcomas (ESTS) do not change significantly in size during preoperative radiation therapy (RT). This cone beam computed tomography study investigates the justification to deliver the entire course with 1 initial RT plan by observing anatomic changes during RT. METHODS AND MATERIALS: Between 2015 and 2017, 99 patients with ESTS were treated with either curative (n = 80) or palliative intent (n = 19) with a regimen of at least 6 fractions...
November 14, 2018: Practical Radiation Oncology
Šimůnek Radim, Adámková-Krákorová Dagmar, Šefr Roman, Fait Vuk
BACKGROUND: Mesenchymal malignancies are relatively rare tumors with distinct behaviors that are usually surgically removal. However, it is sometimes impossible to perform such surgery according to standardized procedures. In particular, surgical removal of intraperitoneal and retroperitoneal tumors differs among individuals. CASE REPORTS: We present two cases with intra-abdominal and retroperitoneal sarcomas who were treated at our comprehensive oncology center...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Panagiotis Tsagozis, Otte Brosjö, Mikael Skorpil
Background: Preoperative radiotherapy is often used to facilitate excision of soft-tissue sarcomas. We aimed define factors that affect local tumour control and patient survival. Methods: A single institution registry study of 89 patients with non-metastatic soft-tissue sarcomas having preoperative radiotherapy between 1994 and 2014. Radiologic (presence of peritumoural oedema and volume change following radiotherapy) and histopathologic (tumour volume, grade and surgical margin) parameters were recorded...
2018: Clinical Sarcoma Research
Jules Lansu, Jan Groenewegen, Frits van Coevorden, Winan van Houdt, Alexander C J van Akkooi, Hester van Boven, Michiel van de Sande, Marcel Verheij, Rick L Haas
AIMS: The purpose of the study was to investigate the time dependent dynamics of wound complications and local control after preoperative radiotherapy (RT) in Extremity Soft Tissue Sarcomas (ESTS). PATIENTS & METHODS: In this retrospective cohort study, all patients treated for an extremity sarcoma with pre-operative radiotherapy followed by surgery were identified from a prospectively maintained database. A wound complication (WC) was defined as any local complication of the surgical area requiring intervention, hospital readmission or significant extension of the initial admission period...
October 6, 2018: European Journal of Surgical Oncology
Sebastian Zschaeck, Peter Wust, Ingo Melcher, Jacek Nadobny, Daniel Rau, Jana Striefler, Stefan Pahl, Anne Flörcken, Annegret Kunitz, Pirus Ghadjar
PURPOSE: Localized adult high-grade soft tissue sarcomas (STS) usually require multimodality treatment including surgery, radiotherapy, chemotherapy and hyperthermia. If maximal preoperative tumor-shrinkage is envisaged, neoadjuvant chemotherapy + radiation (CRT) is often applied, however at the expense of relatively high toxicities and increased postoperative complication rates. This study aims to compare preoperative CRT with neoadjuvant chemotherapy + regional hyperthermia (HCT) regarding histopathological response, toxicity and outcome...
October 9, 2018: International Journal of Hyperthermia
Avani D Rao, Qinyu Chen, Lynn Million, Sheri L Spunt, Thomas J Fitzgerald, Chen Hu, Sandesh S Rao, Fran Laurie, Sandy Kessel, Karen Morano, Matthew M Ladra, Stephanie A Terezakis
PURPOSE: For pediatric patients with large, high-grade, extremity nonrhabdomyosarcoma soft-tissue sarcomas, preoperative radiation therapy (RT) provides the opportunity for smaller radiation fields and tumor shrinkage resulting in less extensive surgery. The potential disadvantage is an increased risk of wound complications after surgery compared with rates after postoperative chemoradiation. We assessed the impact of preoperative RT technique on target coverage in relationship to dose to skin and adjacent joints to determine whether acute wound complications and late musculoskeletal injury might be influenced by treatment technique...
January 1, 2019: International Journal of Radiation Oncology, Biology, Physics
Minglei Yang, Nanzhe Zhong, Chenglong Zhao, Wei Xu, Shaohui He, Jian Zhao, Xinghai Yang, Jianru Xiao
BACKGROUND: Synovial sarcoma (SS) is a soft tissue sarcoma that rarely occurs in the spine, and a minimal number of cases have been reported in the literature. Spinal SS is challenging in diagnosis and treatment and has a poor prognosis. The aim of this study was to summarize and analyse the clinical features and outcomes of patients with spinal SS. METHODS: A total of 16 cases of patients with spinal SS admitted to our institution were reviewed retrospectively...
August 27, 2018: World Journal of Surgical Oncology
Maria Anna Smolle, Michael Parry, Lee Jeys, Seggy Abudu, Robert Grimer
OBJECTIVES: Synovial sarcoma, a distinct subtype of soft tissue sarcomas (STS), is typically found in young patients. Long history of symptoms and heterogeneous clinical presentation sometimes delays diagnosis. Children have been reported to have a better prognosis than adults in some series. The main emphasis of this study was to determine differences between children and adults and to investigate prognostic factors regarding cancer specific survival (CSS). METHODS: 248 patients treated between 1982 and 2014 at one department were included...
July 20, 2018: European Journal of Surgical Oncology
Stephen J Ramey, Raphael Yechieli, Wei Zhao, Joyson Kodiyan, David Asher, Felix M Chinea, Vivek Patel, Isildinha M Reis, Lily Wang, Breelyn A Wilky, Ty Subhawong, Jonathan C Trent
Small randomized trials have not shown an overall survival (OS) difference among local treatment modalities for patients with extremity soft-tissue sarcomas (E-STS) but were underpowered for OS. We examine the impact of local treatment modalities on OS and sarcoma mortality (SM) using two national registries. The National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) Program were analyzed separately to identify patients with stage II-III, high-grade E-STS diagnosed between 2004 and 2013 and treated with (1) amputation alone, (2) limb-sparing surgery (LSS) alone, (3) preoperative radiation therapy (RT) and LSS, or (4) LSS and postoperative RT...
September 2018: Cancer Medicine
Marc G Stevenson, Lukas B Been, Harald J Hoekstra, Albert J H Suurmeijer, Ronald Boellaard, Adrienne H Brouwers
BACKGROUND: This study explores various volume of interest (VOI) delineation techniques for fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18 F-FDG PET-CT) scans during neoadjuvant extremity soft tissue sarcoma (ESTS) treatment. RESULTS: During neoadjuvant treatment, hyperthermic isolated limb perfusion (HILP) and preoperative external beam radiotherapy (EBRT), 11 patients underwent three 18 F-FDG PET-CT scans. The first scan was made prior to the HILP, the second after the HILP but prior to the start of the EBRT, and the third prior to surgical resection...
June 7, 2018: EJNMMI Research
Rick L Haas
This critical review aims to generate hypotheses when to adhere to guidelines and when it could be considered to individualize management of extremity soft tissue sarcomas.Based upon peer-reviewed publications using a PubMed search on the MeSH headings "soft tissue sarcoma" AND "preoperative radiotherapy", data were compiled. Titles and abstracts screened for data including "fraction size AND/OR total dose AND/OR overall treatment time", "chemotherapy", "targeted agents AND/OR tyrosine kinase inhibitors", were screened as well as their respective reference...
August 2018: Chinese Clinical Oncology
Angelo Paolo Dei Tos, Sylvie Bonvalot, Rick Haas
Soft tissue sarcomas are a heterogeneous group of rare malignancies. The diagnostic gold standard is conventional histomorphology with integrated immunohistochemistry. Molecular genetic profiling has identified new subgroups of undifferentiated sarcomas involving genetic rearrangements with creation of fusion genes. Accurate classification of sarcomas is critical for appropriate clinical decision-making which should involve a multidisciplinary team. A preoperative biopsy is necessary to confirm a diagnosis...
May 2018: Future Oncology
A Kaan Gündüz, Emine Temel
Purpose: To describe the clinical presentation, treatment, and outcome of patients with histiocytic lesions of the orbit. Methods: Retrospective study of 9 patients treated and followed up between October 2001 and January 2018. Results: Eight patients in our series were males and one patient was female. The mean age at presentation was 16.8 years (range, 1 to 42 years). All patients had unilateral disease. The most common presenting complaint was upper eyelid swelling in 8 of 9...
January 2018: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Joseph Daniel Pennington, Fritz C Eilber, Frederick R Eilber, Arun S Singh, Jarred P Reed, Bartosz Chmielowski, Jeffrey J Eckardt, Susan V Bukata, Nicholas M Bernthal, Noah Federman, Scott D Nelson, Sarah M Dry, Pin-Chieh Wang, Michael Luu, Michael T Selch, Michael L Steinberg, Anusha Kalbasi, Mitchell Kamrava
OBJECTIVES: The objective of this study was to analyze outcomes for patients with soft tissue sarcoma of the extremities using neoadjuvant ifosfamide-based chemotherapy and hypofractionated reduced dose radiotherapy, followed by limb-sparing surgery. MATERIALS AND METHODS: An Institutional Review Board (IRB)-approved retrospective review of patients treated at a single institution between 1990 and 2013 was performed. In total, 116 patients were identified who received neoadjuvant ifosfamide-based chemotherapy and 28 Gy in 8 fractions of preoperative radiation (equivalent dose in 2 Gray fractions, 31...
December 2018: American Journal of Clinical Oncology
Hisaki Aiba, Satoshi Yamada, Jun Mizutani, Norio Yamamoto, Hideki Okamoto, Katsuhiro Hayashi, Hiroaki Kimura, Akihiko Takeuchi, Shinji Miwa, Takashi Higuchi, Kensaku Abe, Yuta Taniguchi, Yoshihiro Araki, Hiroyuki Tsuchiya, Takanobu Otsuka
PURPOSE: Radio-hyperthermo-chemo (RHC) therapy, which combines radiotherapy, hyperthermia, and chemotherapy, for malignant soft tissue tumors has been introduced with the aim of decreasing the possibility of local recurrence after surgery. To avoid unnecessary neoadjuvant therapy and to plan the appropriate surgical treatment, surveillance of RHC therapeutic efficacy during treatment is necessary. In this study, we determined the optimal response criteria to evaluate the efficacy of RHC by comparing preoperative images before and after RHC with pathological evaluation of necrosis in the resected tumor...
2018: PloS One
P Sargos, T Charleux, R L Haas, A Michot, C Llacer, L Moureau-Zabotto, G Vogin, C Le Péchoux, C Verry, A Ducassou, M Delannes, A Mervoyer, N Wiazzane, J Thariat, M P Sunyach, M Benchalal, J D Laredo, M Kind, P Gillon, G Kantor
PURPOSE: The purpose of this study was to evaluate, during a national workshop, the inter-observer variability in target volume delineation for primary extremity soft tissue sarcoma radiation therapy. METHODS AND MATERIALS: Six expert sarcoma radiation oncologists (members of French Sarcoma Group) received two extremity soft tissue sarcoma radiation therapy cases 1: one preoperative and one postoperative. They were distributed with instructions for contouring gross tumour volume or reconstructed gross tumour volume, clinical target volume and to propose a planning target volume...
April 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Mio Yanagisawa, Alicia A Gingrich, Sean Judge, Chin-Shang Li, Nana Wang, Steven W Thorpe, Amanda R Kirane, Richard J Bold, Arta M Monjazeb, Robert J Canter
BACKGROUND/AIM: The predictive value of serum C-reactive protein (CRP) and neutrophil/lymphocyte (N/L) ratio in soft tissue sarcoma (STS) patients receiving neoadjuvant radiotherapy (RT) has not been analyzed. PATIENTS AND METHODS: From 2007 to 2015, we identified 98 STS patients from a prospective database. Using multivariate analysis, we analyzed CRP and N/L ratios as predictors of overall survival (OS). RESULTS: Mean age of patients was 59 years, 46% were female, and 55% of tumors were located at the extremity...
March 2018: Anticancer Research
Marc G Stevenson, Jojanneke M Seinen, Elisabeth Pras, Adrienne H Brouwers, Robbert J van Ginkel, Barbara L van Leeuwen, Albert J H Suurmeijer, Lukas B Been, Harald J Hoekstra
BACKGROUND: This feasibility study presents the results of a new intensive treatment regimen for locally advanced extremity soft tissue sarcomas (ESTS), consisting of hyperthermic isolated limb perfusion (HILP), preoperative external beam radiotherapy (EBRT), and surgical resection. METHODS: From 2011 to 2016, 11 high grade locally advanced ESTS patients underwent this treatment regimen. Preoperative EBRT (12 × 3 Gy) started <4 weeks following the HILP (TNF-α and melphalan) and the surgical resection was planned to take place <2 weeks following the end of the EBRT...
June 2018: Journal of Surgical Oncology
Marc G Stevenson, Jan F Ubbels, Jelena Slump, Marijn A Huijing, Esther Bastiaannet, Elisabeth Pras, Harald J Hoekstra, Lukas B Been
INTRODUCTION: In extremity soft tissue sarcoma (ESTS), external beam radiotherapy (EBRT) has been used in addition to limb-sparing surgery (LSS). This study aims to identify predictors for major wound complication (MWC) development following EBRT and LSS in ESTS. METHODS: This retrospective study includes ESTS patients treated with EBRT and LSS between 2005 and 2017. Two groups were formed; Group I included preoperatively irradiated patients, whereas Group II included patients who underwent postoperative EBRT...
June 2018: European Journal of Surgical Oncology
Ajay Puri, Ashish Gulia, Saniya Crasto, Tushar Vora, Nehal Khanna, Siddharth Laskar
Background: The impact of postoperative radiotherapy (PORT) on outcomes has been a matter of debate after adequate resection in Ewing's sarcoma of the pelvis. We evaluated our cases after surgical excision in pelvic Ewing's sarcoma and assessed local control and overall survival (OS) with respect to PORT and chemotherapy-induced percentage necrosis. Materials and Methods: Forty four surgically operated patients (June 2002-November 2014) of localized Ewing's sarcoma were retrospectively reviewed...
January 2018: Indian Journal of Orthopaedics
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