Preoperative Chemoradiation (Modified Eilber Protocol) Versus Preoperative/Postoperative Radiotherapy for Soft Tissue...

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• High-risk soft tissue sarcoma (STS) of the extremities/trunk has a 15-30% local recurrence rate.
• The modified Eilber protocol (MEP) combines low-dose chemotherapy and reduced preoperative radiation.
• MEP has shown promise in reducing local recurrence and wound complications.

Purpose of the Study:

• To compare long-term local control and overall survival in STS patients treated with MEP versus standard radiotherapy.
• To evaluate the efficacy of MEP in a population-based cohort.

Main Methods:

• Retrospective analysis of 242 STS patients (2004-2016) from the Alberta Cancer Registry.
• Patients received MEP, preoperative, or postoperative radiotherapy.
• Local recurrence-free survival and overall survival analyzed using Kaplan-Meier and Log-rank tests.

Main Results:

• 100 patients received MEP, 91 preoperative radiation, 51 postoperative radiation.
• No significant differences in local recurrence rates (10% MEP vs. 6.6% pre-op vs. 7.8% post-op).
• No significant differences in local recurrence-free survival, recurrence-free survival, or overall survival between groups.

Conclusions:

• MEP demonstrates non-inferior oncologic outcomes compared to standard preoperative or postoperative radiation for STS.
• MEP achieves comparable results despite a reduced radiation dosage.
• The MEP may be considered an additional treatment option for STS patients.