Feasibility of spacers to facilitate postoperative radiotherapy for retroperitoneal sarcomas

Autor:	Martin Borg, Richard M. Smith, Matthew Borg, Steve Chryssidis, Christopher Dobbins, Susan J. Neuhaus, Raghu Gowda, Jessica Reid
Rok vydání:	2017
Předmět:	Adult Male medicine.medical_specialty medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Port (medical) Laparotomy medicine Humans Radiology Nuclear Medicine and imaging Retroperitoneal Neoplasms 030212 general & internal medicine Aged Retrospective Studies business.industry Australia Soft tissue Sarcoma Retrospective cohort study Prostheses and Implants Perioperative Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Treatment Outcome Oncology 030220 oncology & carcinogenesis Feasibility Studies Female business Progressive disease
Zdroj:	Journal of Medical Imaging and Radiation Oncology. 61:812-818
ISSN:	1754-9477
DOI:	10.1111/1754-9485.12641
Popis:	Introduction The role and timing of postoperative radiotherapy (PORT) in the management of retroperitoneal sarcoma (RPS) remains controversial. Method This is a retrospective cohort review of patients undergoing curative resection for RPS at a single institution between January 2011 and July 2016. Patient selection was through the South Australian Soft Tissue Tumour Multidisciplinary Group (MDT) based at Royal Adelaide Hospital. An individualised approach, including assessment of resectability, histopathological grade and subtype, and radiotherapy considerations, was taken for each patient. Patients offered preoperative radiotherapy or palliation were excluded. A saline-filled spacer was inserted following operative resection. Radiotherapy commenced postoperatively. Patients underwent laparotomy to remove the device approximately 6 weeks post completion of PORT. Primary endpoints were technical feasibility, perioperative morbidity and radiation toxicity. Secondary endpoints were local recurrence (LR), distant recurrence (DR) and death. Results During the study period, 40 patients with RPS were managed through the MDT. Twelve patients (ages 33–78) underwent PORT utilising spacers. Radiotherapy toxicity was reported in four patients and extensive adhesions observed in another four patients during spacer removal. Median follow-up was 35 months (range 4–60). Seven patients remain alive and disease free. Four patients developed LR, three developed DR. Three patients died; two with DR and one with LR. Two patients with recurrent/progressive disease are alive; one with DR and one with LR. Conclusion Use of intraoperative spacers to facilitate PORT is feasible, with acceptable toxicity following resection of RPS. Patient selection for this approach remains to be determined.
Databáze:	OpenAIRE
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