Cost-Effectiveness Analysis of Preoperative Versus Postoperative Radiation Therapy in Extremity Soft Tissue Sarcoma

Qu, Xuanlu; Louie, Alexander V.; Ashman, Jonathan B.; Wasif, Nabil

doi:10.1016/j.ijrobp.2016.10.009

Cited by 12 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, preoperative RT may provide substantial benefit for patients with locally advanced disease, allowing conservative or limb-sparing surgery in marginally-resectable or unresectable STS (5). Finally, costeffectiveness analysis supports preoperative RT in STS (6).…”

Section: Rationale For Preoperative Approachmentioning

confidence: 91%

Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients

Spałek

Rutkowski

2020

Front. Oncol.

View full text Add to dashboard Cite

Section: Rationale For Preoperative Approachmentioning

confidence: 91%

Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients

Spałek

Rutkowski

2020

Front. Oncol.

View full text Add to dashboard Cite

“…Compared with post-operative RT, pre-operative RT is associated with a reduced risk of late complications, such as fibrosis and joint stiffness [8] , [10] , [13] , [14] , [15] . These reduced late complications are potentially further associated with improved long-term functional outcomes and decreased healthcare costs [16] . Yet, pre-operative RT also has disadvantages.…”

Section: Introductionmentioning

confidence: 99%

“…All p values calculated using the Kruskal-Wallis test. complications are potentially further associated with improved long-term functional outcomes and decreased healthcare costs[16]. Yet, pre-operative RT also has disadvantages.…”

mentioning

confidence: 99%

PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma

Moon

Furdock

Rhea

et al. 2021

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…[19] Due to a lower incidence of chronic adverse effects with RTx in the preoperative setting, neoadjuvant RTx also seems to be more cost effective. [20] While the timing of RTx most likely has a minimal (if at all) effect on local control and overall survival, it is essential with regards to wound healing, functional outcome and most important on starting any postoperative sarcoma therapy. It is less likely that a patient irradiated after surgery will display severe wound healing impairment.…”

Section: Discussionmentioning

confidence: 99%

Impaired wound healing after neoadjuvant radiotherapy and resection of soft tissue sarcomas

Bakhshai

Klein

Линднер

et al. 2020

Preprint

View full text Add to dashboard Cite

Background In soft tissue sarcomas (STS) radiotherapy (RTx) may be applied pre- or postoperatively with advantages and disadvantages on either side. We examined the effect of preoperative radiation on wound healing in patients with STS of the extremities and the pelvis. Methods Between August 2008 and March 2011, 32 patients with an average of 54 years (SD 18.7) and with STS (all Grade 2 or 3) were treated with a planned wide resection after neoadjuvant RTx leaving a rim of uninvolved soft tissue around the tumor. Preoperative RTx was given at an average dose of 51,5 Gy (SD 4.6) and mean follow up was 12.2 months (SD 9.8). The results were compared to a consecutive series of 60 patients treated later on without neoadjuvant RTx. Results R0 resection were performed in 31 of 32 patients. Impaired wound healing (IWH) occurred in 19 patients (59%), revision surgery had to be performed in 17 patients (53% of total). Four patients had to undergo 2 or more revisions. One patient had to be amputated and one patient died due to septic complications after revision surgery. IWH was seen more frequently in the lower (18 / 28) than in the upper extremities (1 / 4), yet this was not statistically significant in our series (p = 0.223, Fisher’s exact test). Comorbidities were not found to be of influence. In the control group, revision surgery was necessary in 18% of the patients (p = 0.0006). Conclusions Radiotherapy is effective in local tumour control, but causes a high rate of impaired wound healing (59%), if applied prior to surgery. This frequently resulted in one or more revision surgeries delaying the schedule of further therapies. The authors recommend RTx to be applied only in selected cases in a neoadjuvant setting.

show abstract

Cost-Effectiveness Analysis of Preoperative Versus Postoperative Radiation Therapy in Extremity Soft Tissue Sarcoma

Cited by 12 publications

References 29 publications

Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients

Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients

PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma

Impaired wound healing after neoadjuvant radiotherapy and resection of soft tissue sarcomas

Contact Info

Product

Resources

About