Hypofractionated preoperative radiotherapy for high risk soft tissue sarcomas in a geriatric patient population

Authors

  • Vlatko Potkrajcic University Hospital Tübingen, Clinic for Radiooncology
  • Frank Traub Johannes Gutenberg-University Mainz, Department of Orthopaedics and Traumatology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
  • Barbara Hermes Eberhard-Karls-University Tuebingen, Centre for Soft Tissue Sarcoma, GIST and bone tumours, Otfried-Mueller-Straße 10, 72076 Tuebingen, Germany
  • Marcus Scharpf Eberhard-Karls-University Tuebingen, Institute for Pathology, Liebermeisterstraße 8, 72076 Tuebingen, Germany
  • Jonas Kolbenschlag Eberhard-Karls-University Tuebingen, Department of Hand-, Plastic, Reconstrutive and Burn Surgery, Schnarrenbergstrasse 95, 72076 Tuebingen, Germany
  • Daniel Zips Eberhard-Karls-University Tuebingen, Department of Radiation Oncology, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
  • Frank Paulsen Eberhard-Karls-University Tuebingen, Department of Radiation Oncology, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
  • Franziska Eckert Eberhard-Karls-University Tuebingen, Department of Radiation Oncology, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany

Abstract

Abstract

Objectives: Standard therapy for localised, resectable high risk soft tissue sarcomas consists of wide excision and radiotherapy over several weeks. This treatment schedule is hardly feasible in geriatric and frail patients. In order not to withhold radiotherapy from these patients, hypofractionated radiotherapy with 25 Gy in 5 fractions was evaluated in a geriatric patient population.

 

Methods: A retrospective analysis was performed of 18 geriatric patients with resectable high risk soft tissue sarcomas of extremities and thoracic wall. Wound healing and short term oncologic outcome were analysed. In addition, dose constraints for radiotherapy of the extremities were transferred from normofractionated to hypofractionated radiotherapy regimens.

 

Results: Feasibility was good with 17/18 patients completing treatment as planned. Wound healing complication rate was in the range of published data. Two patients developed local and distant recurrence, two patients isolated distant recurrences. No isolated local recurrences were observed. Dose constraints for hypofractionated radiotherapy are summarized. Keeping the constraints was possible in all cases without compromising the coverage of the target volume.

 

Conclusions: Hypofractionated radiotherapy and surgery was well tolerated even in this specific patient population. With feasibility concerning early wound healing problems and adapted constraints, which allow for the treatment of most resectable extremity tumors, the concept warrants further evaluation in patients unfit for standard radiotherapy.

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Published

2021-12-20

How to Cite

Potkrajcic, V., Traub, F., Hermes, B., Scharpf, M., Kolbenschlag, J., Zips, D., Paulsen, F., & Eckert, F. (2021). Hypofractionated preoperative radiotherapy for high risk soft tissue sarcomas in a geriatric patient population . Radiology and Oncology, 55(4), 459–466. Retrieved from https://radioloncol.com/index.php/ro/article/view/3694

Issue

Section

Clinical oncology