Intraoperative radiotherapy-containing multidisciplinary management of trunk-wall soft-tissue sarcomas

Sole, Claudio V.; Cambeiro, Mauricio; Polo, Alfredo; Montero, Á.; Hernánz, R.; González, Carmen González; Cuervo, M.; Perez, Diandra; Julián, Mikel San; Martı́nez-Monge, Rafael

doi:10.1007/s12094-014-1157-y

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Soft tissue sarcomas (STS) are a relatively rare group of malignancies with multiple histological subtypes [1]. The majority of STS originate from the extremities (46% lower, 13% upper) , but may arise in any region including the torso/trunk (18%) [21,35,39,44], retroperitoneum (13%) [45][46][47][48][49][50], or head and neck (9%) [51,52]. Because STS commonly presents as a painless enlarging mass, diagnosis is often delayed until tumors become large in volume, often abutting critical nerves and vessels [53].…”

Section: Introductionmentioning

confidence: 99%

“…Soft tissue sarcomas (STS) are a relatively rare group of malignancies with multiple histological subtypes [ 1 ]. The majority of STS originate from the extremities (46% lower, 13% upper) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], but may arise in any region including the torso/trunk (18%) [ 21 , 35 , 39 , 44 ], retroperitoneum (13%) [ 45 , 46 , 47 , 48 , 49 , 50 ], or head and neck (9%) [ 51 ,…”

Section: Introductionmentioning

confidence: 99%

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Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Callaghan

Hasibuzzaman

Rodman

et al. 2020

Cancers

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Historically, patients with localized soft tissue sarcomas (STS) of the extremities would undergo limb amputation. It was subsequently determined that the addition of radiation therapy (RT) delivered prior to (neoadjuvant) or after (adjuvant) a limb-sparing surgical resection yielded equivalent survival outcomes to amputation in appropriate patients. Generally, neoadjuvant radiation offers decreased volume and dose of high-intensity radiation to normal tissue and increased chance of achieving negative surgical margins—but also increases wound healing complications when compared to adjuvant radiotherapy. This review elaborates on the current neoadjuvant/adjuvant RT approaches, wound healing complications in STS, and the potential application of novel radioprotective agents to minimize radiation-induced normal tissue toxicity.

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Section: Introductionmentioning

confidence: 99%

“…Soft tissue sarcomas (STS) are a relatively rare group of malignancies with multiple histological subtypes [ 1 ]. The majority of STS originate from the extremities (46% lower, 13% upper) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], but may arise in any region including the torso/trunk (18%) [ 21 , 35 , 39 , 44 ], retroperitoneum (13%) [ 45 , 46 , 47 , 48 , 49 , 50 ], or head and neck (9%) [ 51 ,…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Callaghan

Hasibuzzaman

Rodman

et al. 2020

Cancers

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“…5 Nowadays, multidisciplinary treatment has been the treatment principle for STS patients. [6][7][8][9] However, most clinicians mainly focused on pathophysiologic and clinical features, without addressing the impact of psychological and social factors on cancer.…”

Section: Introductionmentioning

confidence: 99%

“…As the biopsychosocial medical model has been present, psychological and social factors have been more and more emphasized in cancers . Nowadays, multidisciplinary treatment has been the treatment principle for STS patients . However, most clinicians mainly focused on pathophysiologic and clinical features, without addressing the impact of psychological and social factors on cancer.…”

Section: Introductionmentioning

confidence: 99%

Marital status and survival in patients with soft tissue sarcoma: A population‐based, propensity‐matched study

et al. 2019

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Background Marital status serves as an independent prognostic factor for survival in a variety of cancers. However, its prognostic impact on soft tissue sarcoma (STS) has not yet been established. Objective To investigate the impact of marital status on survival outcomes among STS patients. Methods A total of 18 013 STS patients diagnosed between 2004 and 2015 were extracted from Surveillance, Epidemiology, and End Results (SEER) database. The marital status was classified into married, divorced, widowed, and single. Kaplan‐Meier analysis and multivariate Cox proportional hazards regression analysis were conducted to establish the impact of marital status on the overall survival (OS) and cancer‐specific survival (CSS). Subgroup analyses were conducted based on age, SEER historic stage and surgery condition. Propensity score matching (PSM) was used to perform a 1:1 matched‐pair analysis to minimize the group differences caused by covariates. Results Married patients enjoyed better 5‐year overall survival (OS) and 5‐year cancer‐specific survival (CSS), compared with patients who were divorced, widowed, and single, respectively. Multivariate Cox proportional hazards regression analysis revealed that marital status was an independent prognostic and protective factor for survival among STS patients, and unmarried status was associated with higher mortality hazards for both OS and CSS. Additionally, widowed individuals had the highest risks of overall and cancer‐specific mortality compared to other unmarried groups. In the subgroup analyses, similar associations were also found. Furthermore, marital status still remained an independent prognostic and protective factor for both OS and CSS even in 1:1 matched‐pair analysis. Conclusions Marital status was an independent prognostic and protective factor for survival for STS patients. Widowed patients suffered the highest death risks among the unmarried groups.

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“…IORT is an efficient method for tumour control in patients where a residual tumour cannot be removed by surgery (R1 or R2 resection). () Owing to its radiation hygiene and biology the INTRABEAM

®

system by Carl Zeiss Meditec AG is ideally suited for this kind of therapy . With today's systems, the irradiation of only a flat, circular area with a diameter up to 6 cm is possible.…”

Section: Introductionmentioning

confidence: 99%

System and path planning algorithm for low‐kV X‐ray free‐form surface irradiation

Rothfuss

Oesterle

Bürgy

et al. 2018

Robotics Computer Surgery

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Objective: Intraoperative radiotherapy (IORT) after surgical resection using a low‐kV‐X‐ray source is a proven method used in cancer treatment. However, the shape and size of the targeted surface area are limited to the size of the available applicators. This can lead to nonconformal and therefore suboptimal treatment for many patients. Methods: A system is proposed comprising an X‐ray source with an applicator for surface irradiation mounted on a robotic arm. This is controlled by an algorithm designed for planning the required continuous path, enabling irradiation of any desired shape with a controlled dose distribution. Results: The system is shown to be capable of irradiating areas composed of rectangles on a flat surface with a homogeneity index of less than 7% inside the targeted area. Conclusion: The presented results demonstrate the potential of the proposed setup to eliminate the current limitations, leading to better treatment of patients.

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Intraoperative radiotherapy-containing multidisciplinary management of trunk-wall soft-tissue sarcomas

Cited by 7 publications

References 20 publications

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Marital status and survival in patients with soft tissue sarcoma: A population‐based, propensity‐matched study

System and path planning algorithm for low‐kV X‐ray free‐form surface irradiation

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