Pre-Surgery Image-Guided Radiotherapy for Sarcoma Patients Reduces Long-Term Side Effects

Soft Tissue Sarcomas (STS) are relatively rare but deadly cancerous tumors of fat, muscles, nerves, tendons, blood vessels, or connective tissues. Standard treatment includes radiotherapy of the sarcoma which may result in damage to healthy tissue and long-term side effects.

In order to address this issue, a multiyear, multi-institution phase 2 clinical trial was conducted over three years at 18 medical centers across the United States (US) by the US Radiation Therapy Oncology Group (RTOG)/NRG Oncology Group. The trial studied more than 100 patients with STS of the extremities. Under the trial, image-guided radiotherapy was administered, prior to tumor removal surgery, to a much smaller area than is standard for treating STS. To achieve this, a series of images of the tumor were taken every day, and digitally integrated with previous scans. This enabled the researchers to determine a custom tailored radiation dose, to minimize exposure to healthy tissue adjacent to the tumor.

Assessments two years after the radiotherapy treatment showed that long-term side effects were only 10.5%. Patients in a previous study, who received radiation to a larger target area, showed long-term side effects of less than 37%.

The study was published in the February 10, 2015, online issue of the Journal of Clinical Oncology and showed that the new treatment damages less healthy tissue and reduces long-term side effects, while survival rates remained unchanged. The findings were considered a significant advance in clinical cancer research and could establish a new standard for treatment of STS.

Dr. Dian Wang, lead author of the paper, professor of Radiation Oncology at Rush University Medical Center (Chicago, IL, USA), and chair of the NRG Oncology Group commented, “This study proves that we are able to use this modern technology—image-guided radiotherapy—to irradiate smaller target volumes (less normal tissue included) and reduce long term side effects in extremity sarcoma patients compared with conventional radiotherapy.”

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Rush University Medical Center