A moderate dose of preoperative radiotherapy may improve resectability in myxoid liposarcoma
Autor: | A.N. Scholten, Winan J. van Houdt, Rick L. Haas, Pètra M. Braam, Kirsten van Langevelde, Jules Lansu, Yvonne Schrage, Erik van Werkhoven |
---|---|
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Soft Tissue Neoplasms 030218 nuclear medicine & medical imaging 03 medical and health sciences Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine medicine Humans Peripheral Nerves Prospective Studies Pathological Neoadjuvant therapy Hyaline Adiposity Neoadjuvant radiotherapy Soft tissue sarcoma Myxoid liposarcoma business.industry Margins of Excision Soft tissue General Medicine Middle Aged Soft tissue sarcomas Neurovascular bundle medicine.disease Magnetic Resonance Imaging Liposarcoma Myxoid Neoadjuvant Therapy Tumor Burden Myxoid liposarcomas Radiation therapy Adipose Tissue Oncology 030220 oncology & carcinogenesis Preoperative Period Blood Vessels Female Radiotherapy Adjuvant Surgery Dose Fractionation Radiation Radiology business MRI |
Zdroj: | European Journal of Surgical Oncology, 47, 10, pp. 2633-2639 European Journal of Surgical Oncology, 47, 2633-2639 EJSO-European Journal of Surgical Oncology, 47(10), 2633-2639. ELSEVIER SCI LTD |
ISSN: | 2633-2639 0748-7983 |
Popis: | Background: Histotype specific neoadjuvant therapy response data is scarce in soft tissue sarcomas. This study aimed to assess the impact of a moderate radiotherapy (RT) dose on resectability and to correlate MRI parameters to pathological treatment response in Myxoid Liposarcoma (MLS).Methods: This prospective, multicenter, single-arm, phase 2 trial assessed the radiological effects of 36 Gy of preoperative radiotherapy in primary non-metastatic MLS (n=34). Distance of the tumor to the neurovascular bundle, tumor dimensions, fat fraction, enhancing fraction were determined on MRI scans at baseline, after 8 and 16 fractions, and preoperatively. Pathological response was established by central pathology review.Results: Preoperative radiotherapy resulted in a median increase of 2 mm (IQR 0 to 6) of the distance of the tumor to the neurovascular bundle. As compared to baseline, the median change of the tumor volume, craniocaudal diameter and axial diameter at preoperative MRI were -60% (IQR -74 to -41), -19% (IQR -23 to -7) and -20% (IQR -29 to -12), respectively. The median fat fraction of 0.1 (IQR 0.0-0.1) and enhancing fraction of 0.8 (IQR 0.6 to 0.9) at baseline, changed to 0.2 (IQR 0.1 to 0.5) and to 0.5(IQR 0.4 to 0.9) preoperatively, respectively. Radiological signs of response in terms of volume, enhancing fraction and fat fraction were correlated with specific pathological signs of response like hyalinization, necrosis and fatty maturation.Conclusions: A moderate dose of preoperative radiotherapy may improve resectability in MLS and could facilitate achievement of clear margins and function preservation. MRI features which were predictive for expressions of pathological response, can play a role in further personalization of neoadjuvant treatment strategies in order to improve outcome in MLS. (C) 2021 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. |
Databáze: | OpenAIRE |
Externí odkaz: |