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Radiation therapy for retroperitoneal sarcoma: practice patterns in North America
Samantha M Ruff1, Victor Heh2, David J Konieczkowski3
1Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, N924 Doan Hall, 410 W 10th Ave, Columbus, OH, 43210, USA.
Radiation Oncology (London, England)
|March 16, 2024
Summary
Radiation therapy (RT) use for retroperitoneal sarcoma (RPS) decreased overall, shifting towards neoadjuvant treatments. Adjuvant RT use, particularly at lower-volume centers, persists despite no significant survival difference compared to surgery alone.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- The role of radiation therapy (RT) in retroperitoneal sarcoma (RPS) management is debated.
- Understanding current practice patterns for RT in RPS is crucial for optimizing treatment strategies.
Purpose of the Study:
- To analyze trends in the utilization of RT for patients with RPS over time.
- To identify factors associated with the use of neoadjuvant versus adjuvant RT.
- To assess the impact of RT on overall survival in RPS patients.
Main Methods:
- Retrospective analysis of the National Cancer Database (2004-2017).
- Inclusion of patients who underwent surgical resection for RPS.
- Trend analysis using contingency tables and Cochran-Armitage Trend test.
Main Results:
- Overall RT use in RPS decreased by <1% annually.
- Neoadjuvant RT use increased by 13% annually, while adjuvant RT use decreased by 6% annually.
- High-volume centers and tumors >10 cm were linked to neoadjuvant RT; liposarcomas were linked to adjuvant RT. No significant survival difference was observed between surgery alone and surgery with RT.
Conclusions:
- RT use for RPS in the US has declined, with a notable shift towards neoadjuvant application.
- A significant proportion of patients still receive adjuvant RT, often at lower-volume institutions.
- Further research may be warranted to clarify the optimal role of RT in specific RPS subtypes and settings.
