Soft Tissue Sarcoma Adult Clinical Trial
Official title:
Combined Treatment of Patients With Soft Tissue Sarcoma Including Preoperative Stereotactic Radiation Therapy and Postoperative Conformal Radiation Therapy
Combined treatment of soft tissue sarcoma includes 3 steps:
1. step - preoperative stereotactic radiation therapy in hypofractionation mode
2. step - operation
3. step - postoperative conformal radiation therapy in normofractionation mode
Combined treatment of soft tissue sarcoma includes 3 steps:
1. At the first step patient undergoes preoperative stereotactic radiation therapy in
hypofractionation mode. Radiation therapy plan is based on topometric MRI and CT scans.
Radiation therapy plan are performed after MRI and CT fusion, contouring of the target
and surrounding normal tissues.
At first step only tumor and, if necessary, the surrounding normal tissues, which will
be removed during surgery, are exposed to radiation.
GTV - determined in with the boundaries of the tumor visualised by topometric MRI and CT
CTV1 - match GTV CTV2 - formed inward (to the tumor center) from GTV by 0.5-1 cm
(depending on the proximity of functionally significant normal tissues (neurovascular
bundles, bone tissue, skin and subcutaneous fat, etc.) PTV - 3-5 mm indent from CTV1,
taking into account the proximity of functionally significant normal tissues and the
planned surgery Preoperative radiation therapy is carried in 5 fractions with a single
dose on PTV - 5 Gy, a single dose on CTV2 - 7 Gy.
2. Second step is surgery in 14-21 days.
3. In 25-35 days after the surgery postoperative conformal radiation therapy is performed
according to the standard protocol GTV (tumor bed) - based on the volume of the primary
tumor, including the swelling zone (T2-weighted images on preoperative MRI) СTV - formed
with an indent of 4 cm from GTV (without going beyond the boundaries of the involved
compartment), in the transverse direction the indent could be reduced to 2 cm.
PTV - formed with an indent of 0.5-1cm from CTV An important condition for planning radiation
therapy is to limit the dose absorbed during both stages of radiation therapy in surrounding
normal tissues that are not removed during surgery.
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