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
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