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USF-LVHN SELECT
Novel Postoperative Hypofractionated Accelerated Radiation Dose-Painting Approach for Soft Tissue Sarcoma.
Publication/Presentation Date
3-1-2024
Abstract
PURPOSE: Hypofractionated radiation therapy (RT) offers benefits in the treatment of soft tissue sarcomas (STS), including exploitation of the lower α/β, patient convenience, and cost. This study evaluates the acute toxicity of a hypofractionated accelerated RT dose-painting (HARD) approach for postoperative treatment of STS.
METHODS AND MATERIALS: This is a retrospective review of 53 consecutive patients with STS who underwent resection followed by postoperative RT. Standard postoperative RT dosing for R0/R1/gross disease with sequential boost (50 Gy + 14/16/20 Gy in 32-35 fractions) were replaced with dose-painting, which adapts dose based on risk of disease burden, to 50.4 and 63, 64.4, 70 Gy in 28 fractions, respectively. The first 10 patients were replanned with a sequential boost RT approach and dosimetric indices were compared. Time-to-event outcomes, including local control, regional control, distant control, and overall survival, were estimated with Kaplan-Meier analysis.
RESULTS: Median follow-up was 25.2 months. Most patients had high-grade (59%) STS of the extremity (63%) who underwent resection with either R1 (40%) or close (36%) margins. Four patients experienced grade 3 acute dermatitis which resolved by the 3-month follow-up visit. The 2-year local control, regional control, distant control, and overall survival were 100%, 92%, 68%, and 86%, respectively. Compared with the sequential boost plan, HARD had a significantly lower field size (total V50 Gy;
CONCLUSIONS: In addition to benefits in cost, convenience, and improved biologic effect in STS, HARD regimen offers a safe treatment approach with dosimetric advantages compared with conventional sequential boost, which may translate to improved long-term toxicity.
Volume
9
Issue
3
First Page
101391
Last Page
101391
ISSN
2452-1094
Published In/Presented At
Mills, M., Miller, J., Liveringhouse, C., Bryant, J. M., Kawahara, Y., Feygelman, V., Latifi, K., Yang, G., Johnstone, P. A., & Naghavi, A. O. (2023). Novel Postoperative Hypofractionated Accelerated Radiation Dose-Painting Approach for Soft Tissue Sarcoma. Advances in radiation oncology, 9(3), 101391. https://doi.org/10.1016/j.adro.2023.101391
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
38495036
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article