open access

Vol 70, No 6 (2020)
Other materials agreed with the Editors
Published online: 2020-12-04
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Current advances in radiotherapy for soft tissue sarcomas

Mateusz J. Spałek, Aneta M. Borkowska
DOI: 10.5603/NJO.2020.0056
·
Nowotwory. Journal of Oncology 2020;70(6):288-295.

open access

Vol 70, No 6 (2020)
Conference addendum
Published online: 2020-12-04

Abstract

Radiotherapy (RT) is a part of the routine treatment of locally advanced or high-grade soft-tissue sarcomas (STS). However, RT has changed significantly over the last 20 years. Modern RT techniques have extended its potential application in STS treatment. That includes advances in contouring, fractionation regimens, RT techniques and combined treatment. This article summarizes the available data, current strategies and future research directions in RT for STS.

Abstract

Radiotherapy (RT) is a part of the routine treatment of locally advanced or high-grade soft-tissue sarcomas (STS). However, RT has changed significantly over the last 20 years. Modern RT techniques have extended its potential application in STS treatment. That includes advances in contouring, fractionation regimens, RT techniques and combined treatment. This article summarizes the available data, current strategies and future research directions in RT for STS.

Get Citation

Keywords

sarcoma; radiotherapy; intensity-modulated radiotherapy; image-guided radiotherapy; brachytherapy

About this article
Title

Current advances in radiotherapy for soft tissue sarcomas

Journal

Nowotwory. Journal of Oncology

Issue

Vol 70, No 6 (2020)

Article type

Other materials agreed with the Editors

Pages

288-295

Published online

2020-12-04

DOI

10.5603/NJO.2020.0056

Bibliographic record

Nowotwory. Journal of Oncology 2020;70(6):288-295.

Keywords

sarcoma
radiotherapy
intensity-modulated radiotherapy
image-guided radiotherapy
brachytherapy

Authors

Mateusz J. Spałek
Aneta M. Borkowska

References (57)
  1. Casali PG, Abecassis N, Aro HT, et al. ESMO Guidelines Committee and EURACAN. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29(Suppl 4): iv51–iv67.
  2. von Mehren M, Randall RL, Benjamin RS, et al. Soft Tissue Sarcoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2018; 16(5): 536–563.
  3. Spałek MJ, Kozak K, Czarnecka AM, et al. Neoadjuvant Treatment Options in Soft Tissue Sarcomas. Cancers (Basel). 2020; 12(8).
  4. RTOG Extremity Soft Tissue Sarcoma Atlas. https://www.rtog.org/CoreLab/ContouringAtlases/RTOGExtremitySoftTissueSarcomaAtlas.aspx (20.06.2020).
  5. Robinson MH, Gaunt P, Grimer R, et al. Vortex Trial: A Randomized Controlled Multicenter Phase 3 Trial of Volume of Postoperative Radiation Therapy Given to Adult Patients With Extremity Soft Tissue Sarcoma (STS). Int J Radiat Oncol Biol Phys. 2016; 96(2): S1.
  6. Wang D, Zhang Q, Eisenberg BL, et al. Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial. J Clin Oncol. 2015; 33(20): 2231–2238.
  7. Haas RLM, Delaney TF, O'Sullivan B, et al. Radiotherapy for management of extremity soft tissue sarcomas: why, when, and where? Int J Radiat Oncol Biol Phys. 2012; 84(3): 572–580.
  8. van Leeuwen CM, Oei AL, Crezee J, et al. The alfa and beta of tumours: a review of parameters of the linear-quadratic model, derived from clinical radiotherapy studies. Radiat Oncol. 2018; 13(1): 96.
  9. Haas RLM, Miah AB, LePechoux C, et al. Preoperative radiotherapy for extremity soft tissue sarcoma; past, present and future perspectives on dose fractionation regimens and combined modality strategies. Radiother Oncol. 2016; 119(1): 14–21.
  10. Kalbasi A, Kamrava M, Chu FI, et al. A Phase II Trial of 5-Day Neoadjuvant Radiotherapy for Patients with High-Risk Primary Soft Tissue Sarcoma. Clin Cancer Res. 2020; 26(8): 1829–1836.
  11. Koseła-Paterczyk H, Szacht M, Morysiński T, et al. Preoperative hypofractionated radiotherapy in the treatment of localized soft tissue sarcomas. Eur J Surg Oncol. 2014; 40(12): 1641–1647.
  12. Koseła-Paterczyk H, Spałek M, Borkowska A, et al. Hypofractionated Radiotherapy in Locally Advanced Myxoid Liposarcomas of Extremities or Trunk Wall: Results of a Single-Arm Prospective Clinical Trial. J Clin Med. 2020; 9(8).
  13. Spałek M, Koseła-Paterczyk H, Borkowska A, et al. Hypofractionated Radiotherapy in Locally Advanced Myxoid Liposarcomas of Extremities or Trunk Wall: Results of a Single Arm Prospective Clinical Trial. Int J Radiat Oncol Biol Phys. 2019; 105(1): S63.
  14. Spalek M, Koseła-Paterczyk H, Borkowska A, et al. OC-0069 5x5 Gy with chemotherapy in borderline resectable soft tissue sarcomas: early results of a trial. Radiotherapy and Oncology. 2019; 133: S31–S32.
  15. Spałek MJ, Rutkowski P. Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients. Front Oncol. 2020; 10: 993.
  16. Davis AM, O'Sullivan B, Turcotte R, et al. Canadian Sarcoma Group, NCI Canada Clinical Trial Group Randomized Trial. Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother Oncol. 2005; 75(1): 48–53.
  17. O'Sullivan B, Davis A, Turcotte R, et al. Five-year results of a randomized phase III trial of pre-operative vs post-operative radiotherapy in extremity soft tissue sarcoma. Journal of Clinical Oncology. 2004; 22(14_suppl): 9007–9007.
  18. O'Sullivan B, Davis A, Turcotte R, et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. The Lancet. 2002; 359(9325): 2235–2241.
  19. O'Sullivan B, Griffin AM, Dickie CI, et al. Phase 2 study of preoperative image-guided intensity-modulated radiation therapy to reduce wound and combined modality morbidities in lower extremity soft tissue sarcoma. Cancer. 2013; 119(10): 1878–1884.
  20. Haas RL, van Beek S, Betgen A, et al. Substantial Volume Changes and Plan Adaptations During Preoperative Radiation Therapy in Extremity Soft Tissue Sarcoma Patients. Pract Radiat Oncol. 2019; 9(2): 115–122.
  21. Abu-Hijlih R, Mheid S, Abuhijla F, et al. Adaptive radiotherapy in patients receiving neoadjuvant radiation for soft tissue sarcoma. Rep Pract Oncol Radiother. 2019; 24(3): 263–268.
  22. Levin WP, Kooy H, Loeffler JS, et al. Proton beam therapy. Br J Cancer. 2005; 93(8): 849–854.
  23. Frisch S, Timmermann B. The Evolving Role of Proton Beam Therapy for Sarcomas. Clin Oncol (R Coll Radiol). 2017; 29(8): 500–506.
  24. Demizu Y, Jin D, Sulaiman N, et al. Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis. Int J Radiat Oncol Biol Phys. 2017; 98(2): 367–374.
  25. Imai R, Kamada T, Araki N, et al. Working Group for Carbon Ion Radiotherapy for Bone and Soft Tissue Sarcomas. Carbon ion radiotherapy for unresectable localized axial soft tissue sarcoma. Cancer Med. 2018; 7(9): 4308–4314.
  26. Yang J, Gao J, Wu X, et al. Salvage Carbon Ion Radiation Therapy for Locally Recurrent or Radiation-Induced Second Primary Sarcoma of the Head and Neck. J Cancer. 2018; 9(12): 2215–2223.
  27. Sugahara S, Kamada T, Imai R, et al. Working Group for the Bone and Soft Tissue Sarcomas. Carbon ion radiotherapy for localized primary sarcoma of the extremities: results of a phase I/II trial. Radiother Oncol. 2012; 105(2): 226–231.
  28. Pisters PW, Harrison LB, Leung DH, et al. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol. 1996; 14(3): 859–868.
  29. Harrison L, Franzese F, Gaynor J, et al. Long-term results of a prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcomas of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys. 1993; 27(2): 259–265.
  30. Brennan MF, Hilaris B, Shiu MH, et al. Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. Arch Surg. 1987; 122(11): 1289–1293.
  31. Zelefsky M, Nori D, Shiu M, et al. Limb salvage in soft tissue sarcomas involving neurovascular structures using combined surgical resection and brachytherapy. Int J Radiat Oncol Biol Phys. 1990; 19(4): 913–918.
  32. Nag S, Olson T, Ruymann F, et al. High-dose-rate brachytherapy in childhood sarcomas: a local control strategy preserving bone growth and function. Med Pediatr Oncol. 1995; 25(6): 463–469.
  33. Nag S, Martínez-Monge R, Ruymann F, et al. Innovation in the management of soft tissue sarcomas in infants and young children: high-dose-rate brachytherapy. J Clin Oncol. 1997; 15(9): 3075–3084.
  34. Bradley JA, Kleinman SH, Rownd J, et al. Adjuvant high dose rate brachytherapy for soft tissue sarcomas: initial experience report. J Contemp Brachytherapy. 2011; 3(1): 3–10.
  35. Alekhteyar K, Leung D, Brennan M, et al. The effect of combined external beam radiotherapy and brachytherapy on local control and wound complications in patients with high-grade soft tissue sarcomas of the extremity with positive microscopic margin. Int J Radiat Oncol Biol Phys. 1996; 36(2): 321–324.
  36. Naghavi AO, Fernandez DC, Mesko N, et al. American Brachytherapy Society consensus statement for soft tissue sarcoma brachytherapy. Brachytherapy. 2017; 16(3): 466–489.
  37. Issels RD, Lindner LH, Verweij J, et al. European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC-STBSG), European Society for Hyperthermic Oncology (ESHO). Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol. 2010; 11(6): 561–570.
  38. Issels RD, Lindner LH, Verweij J, et al. European Organization for the Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group and the European Society for Hyperthermic Oncology. Effect of Neoadjuvant Chemotherapy Plus Regional Hyperthermia on Long-term Outcomes Among Patients With Localized High-Risk Soft Tissue Sarcoma: The EORTC 62961-ESHO 95 Randomized Clinical Trial. JAMA Oncol. 2018; 4(4): 483–492.
  39. de Jong MAA, Oldenborg S, Bing Oei S, et al. Reirradiation and hyperthermia for radiation-associated sarcoma. Cancer. 2012; 118(1): 180–187.
  40. Eschrich SA, Pramana J, Zhang H, et al. A gene expression model of intrinsic tumor radiosensitivity: prediction of response and prognosis after chemoradiation. Int J Radiat Oncol Biol Phys. 2009; 75(2): 489–496.
  41. Yang GQ, Yuan ZM, Welsh E, et al. Intrinsic Radiosensitivity Index Differences of Sarcoma and the Potential for Genome-Adjusted Radiation Dosing. Int J Radiat Oncol Biol Phys. 2019; 105(1): E812.
  42. Nolan MW, Gieger TL, Karakashian AA, et al. Outcomes of Spatially Fractionated Radiotherapy (GRID) for Bulky Soft Tissue Sarcomas in a Large Animal Model. Technol Cancer Res Treat. 2017; 16(3): 357–365.
  43. Wu X, Ahmed M, Wright J, et al. ON MODERN TECHNICAL APPROACHES OF THREE-DIMENSIONAL HIGH-DOSE LATTICE RADIOTHERAPY (LRT). Cureus. 2010.
  44. Amendola B, Perez N, Amendola M, et al. LATTICE Radiotherapy with RapidArc for Treatment of Gynecological Tumors:Dosimetric and Early Clinical Evaluations. Cureus. 2010.
  45. Suarez JB, Amendola B, Perez N, et al. The Use of Lattice Radiation Therapy (LRT) in the Treatment of Bulky Tumors: A Case Report of a Large Metastatic Mixed Mullerian Ovarian Tumor. Cureus. 2015.
  46. Kudrimoti M, Mohiuddin M, Ahmed M, et al. Use of high dose spatially fractionated radiation (GRID therapy) in management of large, poor prognostic stage III (>10cms) soft tissue sarcomas. Int J Radiat Oncol Biol Phys. 2004; 60(1): S575.
  47. Mohiuddin M, Memon M, Nobah A, et al. Locally advanced high-grade extremity soft tissue sarcoma: Response with novel approach to neoadjuvant chemoradiation using induction spatially fractionated GRID radiotherapy (SFGRT). J Clin Oncol. 2014; 32(15_suppl): 10575–10575.
  48. Bonvalot S, Gronchi A, Péchoux CLe, et al. Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2020; 21(10): 1366–1377.
  49. Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol. 2009; 27(1): 31–37.
  50. Kelly KJ, Yoon SS, Kuk D, et al. Comparison of Perioperative Radiation Therapy and Surgery Versus Surgery Alone in 204 Patients With Primary Retroperitoneal Sarcoma: A Retrospective 2-Institution Study. Ann Surg. 2015; 262(1): 156–162.
  51. Bates JE, Dhakal S, Mazloom A, et al. The Benefit of Adjuvant Radiotherapy in High-grade Nonmetastatic Retroperitoneal Soft Tissue Sarcoma: A SEER Analysis. Am J Clin Oncol. 2018; 41(3): 274–279.
  52. Temple WJ, Temple CL, Arthur K, et al. Prospective cohort study of neoadjuvant treatment in conservative surgery of soft tissue sarcomas. Ann Surg Oncol. 1997; 4(7): 586–590.
  53. Ryan CW, Montag AG, Hosenpud JR, et al. Histologic response of dose-intense chemotherapy with preoperative hypofractionated radiotherapy for patients with high-risk soft tissue sarcomas. Cancer. 2008; 112(11): 2432–2439.
  54. MacDermed DM, Miller LL, Peabody TD, et al. Primary tumor necrosis predicts distant control in locally advanced soft-tissue sarcomas after preoperative concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2010; 76(4): 1147–1153.
  55. Meyer JM, Perlewitz KS, Hayden JB, et al. Phase I trial of preoperative chemoradiation plus sorafenib for high-risk extremity soft tissue sarcomas with dynamic contrast-enhanced MRI correlates. Clin Cancer Res. 2013; 19(24): 6902–6911.
  56. Pennington JD, Eilber FC, Eilber FR, et al. Long-term Outcomes With Ifosfamide-based Hypofractionated Preoperative Chemoradiotherapy for Extremity Soft Tissue Sarcomas. Am J Clin Oncol. 2018; 41(12): 1154–1161.
  57. Parsai S, Lawrenz J, Mesko N, et al. Early Outcomes of Preoperative 5-fraction Radiation Therapy for Soft Tissue Sarcoma with Immediate Resection. Int J Radiat Oncol Biol Phys. 2019; 105(1): E809–E810.

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