Sarcoma Clinical Trial
Official title:
Preoperative IMRT for Soft Tissue Sarcoma of the Extremities and Trunk: Low Rate of Wound Complications
Postoperative wound healing complications following preoperative radiotherapy represent a severe problem in the treatment of malignant soft tissue tumors, and are reported to be 34% and more. The literature discusses intensely the advantages and disadvantages of this multimodal treatment concept and there are different opinions. The Canadian prospective randomized NCIC SR2 trial showed increased wound complication rates in the study arm receiving preoperative radiation. The Sarcoma Center Zurich pursues mainly this treatment concept and the results shall now be analysed and published. The approach is to show that not only the complication rates are comparable to international bench marks, but also the (still intermediate time) local control rates.
Introduction: The Canadian prospective randomized NCIC SR2 trial tested the sequence of
radiation and surgery for soft tissue sarcoma of the extremities. Similar disease control
rates following pre- versus postoperative non-intensity modulated radiation therapy
(non-IMRT) was found, with increased wound complications (17% vs 35%) in the preoperative
radiation arm, [95% CI 5-30], p=0·01).
The investigators assessed a single center preoperative IMRT (or IMRT-equivalent highly
conformal three dimensional conventional RT (3DcRT)) cohort with respect to the wound
complication rate (WCR). The hypothesis was that a lower WCR rate was achieved in the era of
IMRT as compared to the non-IMRT era when the Canadian Trial was conducted.
Methods: 67 consecutive patients irradiated with 50Gy in 25 fractions between 3/2008-3/2016
with preoperative IMRT (n=48, 72%) or highly conformal IMRT-equivalent 3DcRT dose
distribution (n=19, 28%) were assessed. All patients were previously discussed at the weekly
interdisciplinary sarcoma board of the Sarcoma Center Zurich.
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