Feasibility and safety study of ultra-hypofractionated neoadjuvant radiotherapy to margins-at-risk in retroperitoneal sarcoma

• 발행기관: 대한방사선종양학회
• 저자명: Ru-Xin Wong Valerie Shi Wen Yang Clarame Shulyn Chia Wen Shen Looi Wen Long Nei Chin-Ann Johnny Ong
• 간행물 정보: 『대한방사선종양학회지』제43권 제1호, 6~12쪽, 전체 7쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2025.03.31

국문 초록

Purpose: Retroperitoneal sarcomas (RPS) are rare tumors that present unique challenges, often due to late presentation, and the proximity of critical organs makes complete surgical resection challenging. This study aimed to assess the feasibility of neoadjuvant short-course radiotherapy (SCRT) targeting margins-at-risk and to assess its potential impact on outcomes. Materials and Methods: This is a single-center, prospective, non-randomized feasibility study. SCRT was administered via image-guided volumetric modulated arc therapy, consisting of 5 fractions of daily radiotherapy followed by immediate surgery. As a starting dose, patients were prescribed 25 Gy in 5 fractions. For the escalation stage, patients were prescribed 30 Gy in 5 fractions. Only the presumed threatened surgical margins were delineated for large tumors. Results: Patients with either primary or recurrent RPS were recruited. Eight patients underwent SCRT but one patient did not have a resection as planned. Seven patients underwent surgical resection, of whom one passed away 3 months postoperative from a cardiac event. After a median follow-up of 20.5 months for the six postoperative survivors, there were no overt long-term toxicities and one patient relapsed out-of-radiotherapy-field. Conclusion: SCRT to RPS with a margin boost followed by immediate surgery is worth investigating. A starting dose of 30 Gy in 5 fractions is recommended for further studies. Longer-term follow-up is necessary.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Acknowledgments

Funding

Author Contributions

Data Availability Statement

References

키워드

Sarcoma Radiotherapy Neoadjuvant therapy Preoperative procedures