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Intra-operative radiotherapy in soft tissue sarcomas
J B Dubois1, C Debrigode, M Hay
1Department of Radiotherapy, C.R.L.C. Val d'Aurelle, Paul Lamarque, Montpellier, France.
Summary
Intraoperative radiation therapy (IORT) combined with surgery achieved 87% local control in 31 soft tissue sarcoma patients. This treatment shows promise for managing these challenging tumors effectively.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Soft tissue sarcomas are rare malignancies requiring multimodal treatment approaches.
- Intraoperative radiation therapy (IORT) is an option for achieving high local doses in surgically accessible tumors.
Purpose of the Study:
- To evaluate the efficacy of intraoperative radiation therapy (IORT) combined with surgical excision in patients with soft tissue sarcomas.
- To assess local control rates and survival outcomes in patients treated with IORT.
Main Methods:
- A cohort of 31 patients with soft tissue sarcomas underwent surgical excision followed by IORT.
- Tumor sites included pelvis, retroperitoneal spaces, limbs, and trunk, with various histological subtypes.
- Patients received varying single doses of IORT (10-25 Gy), with 16 patients also receiving postoperative external beam radiation therapy.
Main Results:
- Local control (LC) was achieved in 27 out of 31 patients (87%) with a minimum follow-up of 2 years.
- Eleven patients died, seven with local control (one intercurrent disease, six distant metastasis) and four with local failure within IORT fields.
- Nineteen patients are alive with no evidence of disease, and one patient is alive with distant metastasis.
Conclusions:
- IORT combined with complete surgical excision provides high rates of local control for soft tissue sarcomas.
- The treatment strategy appears effective in managing both primary and recurrent soft tissue sarcomas.
- Further investigation into optimizing IORT parameters and patient selection may further improve outcomes.