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Soft tissue sarcoma is a malignant tumor derived from fat, fascia, muscle, fiber, lymph and blood vessels, with different histological and biological characteristics, and different soft tissue sarcomas have different
local infiltration, hematogenous and lymphatic metastasis tendencies.
The incidence is higher in the elderly, and there is no sex difference
.
Soft tissue sarcomas can occur anywhere, and about 75% of lesions are located on the extremities (most commonly in the thighs).
The standard preoperative radiotherapy regimen for soft tissue sarcoma is 50 Gy divided into 25 sessions for 5 weeks and provides good local control, but major wound complications
occur in about 35% of patients.
The aim of the study was to assess the safety
of moderately low fractionation, shorter course of radiotherapy.
This is a single-center, open-label, single-arm Phase 2 trial that enrolled patients aged 18 years and older with non-metastatic soft tissue sarcoma and preoperatively received a total dose of 42.
75 Gy (2.
85 Gy daily in 15 divided doses for 3 weeks).
The primary endpoint was the occurrence of major wound complications within 120 days of
surgery.
From December 18, 2018 to January 6, 2021, a total of 157 patients were screened, of whom 120 were enrolled in hypofractionated preoperative radiotherapy
.
The median postoperative follow-up was 24 months (IQR 17-30).
Of the 120 patients, 37 (31%) developed major wound complications
at a median postoperative follow-up of 37 days.
No patients experienced grade 3 or greater radiotherapy toxicity or treatment-related serious adverse effects
during or within 4 weeks after the end of radiotherapy.
Four of the 115 patients (3%) experienced at least grade 3 late radiation toxicity (after 6 months postoperatively): femoral fracture (n=2), lymphedema (n=1), skin ulceration (n=1).
There were no treatment-related deaths
.
In conclusion, hypofractionated radiotherapy for patients with soft tissue sarcoma before surgery is safe, more convenient for patients, or can replace conventional fractionated radiotherapy
.
Original source:
B Ashleigh Guadagnolo, et al.
Hypofractionated, 3-week, preoperative radiotherapy for patients with soft tissue sarcomas (HYPORT-STS): a single-centre, open-label, single-arm, phase 2 trial.
The Lancet Oncology.
November 04, 2022.
https://doi.
org/10.
1016/S1470-2045(22)00638-6
