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Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial.

Publication ,  Journal Article
Wang, D; Zhang, Q; Eisenberg, BL; Kane, JM; Li, XA; Lucas, D; Petersen, IA; DeLaney, TF; Freeman, CR; Finkelstein, SE; Hitchcock, YJ; Bedi, M ...
Published in: J Clin Oncol
July 10, 2015

PURPOSE: We performed a multi-institutional prospective phase II trial to assess late toxicities in patients with extremity soft tissue sarcoma (STS) treated with preoperative image-guided radiation therapy (IGRT) to a reduced target volume. PATIENTS AND METHODS: Patients with extremity STS received IGRT with (cohort A) or without (cohort B) chemotherapy followed by limb-sparing resection. Daily pretreatment images were coregistered with digitally reconstructed radiographs so that the patient position could be adjusted before each treatment. All patients received IGRT to reduced tumor volumes according to strict protocol guidelines. Late toxicities were assessed at 2 years. RESULTS: In all, 98 patients were accrued (cohort A, 12; cohort B, 86). Cohort A was closed prematurely because of poor accrual and is not reported. Seventy-nine eligible patients from cohort B form the basis of this report. At a median follow-up of 3.6 years, five patients did not have surgery because of disease progression. There were five local treatment failures, all of which were in field. Of the 57 patients assessed for late toxicities at 2 years, 10.5% experienced at least one grade ≥ 2 toxicity as compared with 37% of patients in the National Cancer Institute of Canada SR2 (CAN-NCIC-SR2: Phase III Randomized Study of Pre- vs Postoperative Radiotherapy in Curable Extremity Soft Tissue Sarcoma) trial receiving preoperative radiation therapy without IGRT (P < .001). CONCLUSION: The significant reduction of late toxicities in patients with extremity STS who were treated with preoperative IGRT and absence of marginal-field recurrences suggest that the target volumes used in the Radiation Therapy Oncology Group RTOG-0630 (A Phase II Trial of Image-Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity) study are appropriate for preoperative IGRT for extremity STS.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

July 10, 2015

Volume

33

Issue

20

Start / End Page

2231 / 2238

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Sarcoma
  • Risk Factors
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Image-Guided
  • Radiotherapy, Conformal
  • Radiotherapy, Adjuvant
 

Citation

APA
Chicago
ICMJE
MLA
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Wang, D., Zhang, Q., Eisenberg, B. L., Kane, J. M., Li, X. A., Lucas, D., … Kirsch, D. G. (2015). Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial. J Clin Oncol, 33(20), 2231–2238. https://doi.org/10.1200/JCO.2014.58.5828
Wang, Dian, Qiang Zhang, Burton L. Eisenberg, John M. Kane, X Allen Li, David Lucas, Ivy A. Petersen, et al. “Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial.J Clin Oncol 33, no. 20 (July 10, 2015): 2231–38. https://doi.org/10.1200/JCO.2014.58.5828.
Wang D, Zhang Q, Eisenberg BL, Kane JM, Li XA, Lucas D, Petersen IA, DeLaney TF, Freeman CR, Finkelstein SE, Hitchcock YJ, Bedi M, Singh AK, Dundas G, Kirsch DG. Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial. J Clin Oncol. 2015 Jul 10;33(20):2231–2238.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

July 10, 2015

Volume

33

Issue

20

Start / End Page

2231 / 2238

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Sarcoma
  • Risk Factors
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Image-Guided
  • Radiotherapy, Conformal
  • Radiotherapy, Adjuvant