Neoadjuvant radiotherapy for retroperitoneal sarcoma: A systematic review

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Multimodal treatment for retroperitoneal sarcoma (RPS) increasingly incorporates neoadjuvant radiation.
• The efficacy of neoadjuvant radiation in reducing local recurrence and improving survival in RPS remains a subject of debate.

Purpose of the Study:

• To systematically review and evaluate the existing literature on the use of neoadjuvant radiation therapy for retroperitoneal sarcoma.
• To synthesize data on patient outcomes, including survival and local recurrence, and treatment-related toxicities.

Main Methods:

• A literature review was conducted adhering to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines.
• Inclusion and exclusion criteria were pre-specified to ensure study quality and relevance.
• Data extraction focused on patient demographics, tumor characteristics, treatment regimens, and outcomes.

Main Results:

• The review analyzed 15 studies comprising 464 patients with retroperitoneal sarcoma, predominantly liposarcoma and leiomyosarcoma.
• Median 5-year overall survival (OS), progression-free survival (PFS), and local recurrence (LRR) rates were 58%, 71.5%, and 25%, respectively.
• Treatment-related toxicities were reported, with varying grades of severity, indicating a generally manageable safety profile.

Conclusions:

• Neoadjuvant radiation therapy (NART) appears to be a safe component of multimodal treatment for retroperitoneal sarcoma.
• The definitive impact of NART on survival and local control in RPS is not yet clearly established.
• Standardized reporting criteria and the initiation of randomized controlled trials are crucial for advancing the understanding and application of NART in RPS management.