Myxoid Liposarcoma Clinical Trial
Official title:
Hypofractionated 5x5 Gy Radiotherapy With Prolonged Gap Before Surgery in Preoperative Treatment of Patients With Locally Advanced Myxoid Liposarcomas of Extremities or Trunk Wall
After a screening, which consists of pathology confirmation, physical examination, magnetic resonance imaging (MRI), body computed tomography (CT) scan, blood tests, and case analysis on Multidisciplinary Team (MDT) meeting, patient will be irradiated 5x5 Gy and after radiotherapy and then referred for surgery 6-8 weeks after the radiotherapy completion.
Myxoid liposarcoma has been reported to be more radiosensitive compared with other soft
tissue sarcomas (STS). Response to preoperative treatment involves in decrease in tumor size,
a large percentage in tumor necrosis (which according to some reports has a beneficial effect
on the reduction of local recurrence rates) and also among other in a change in vasculature
of the tissue.
Hypofractionation represents a variation of radiotherapy fractionation in which the total
dose is divided into fewer fractions with an increased fraction dose. Such treatment may lead
to additional biological effects when compared to conventionally fractionated radiotherapy
(eg. vascular damage, increased immunogenicity, and antigenicity). The main advantages of
hypofractionation are those related to the decreased overall treatment time what is more
convenient for both patients and physicians, increased compliance and makes the treatment
more cost-effective. Intriguing, such an approach may provide an additional benefit when
treating non-radiosensitive tumors with a low alpha/beta ratio (eg. sarcomas).
The use of preoperative hypofractionated radiotherapy 5x5 Gy for five consecutive days, and
then immediate surgery in patients with locally advanced soft tissue sarcomas showed in a
published study a good local control rate, with a favorable amount of late toxicities. In
this patient population, there were 22 patients with primary myxoid liposarcoma and the local
control rate in this group was 86%.
In the proposed study we plan to increase the gap between the end of radiotherapy and surgery
to commonly applied five weeks to better assess the changes occurring in the tumor after
treatment and to evaluate the impact of longer treatment interval on reducing the proportion
of early complications of treatment.
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