Surgical management of retroperitoneal sarcomas associated with external and intraoperative electron beam radiotherapy

Bobin, Jean Yves; Al-Lawati, Taha; Granero, L.E.; Adham, M.; Romestaing, P.; Chapet, O.; Issac, S.; Jp, Gérard

doi:10.1016/s0748-7983(03)00139-2

Cited by 42 publications

(16 citation statements)

References 33 publications

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“…IORT combined with resection and EBRT offers an effective means of improving LC in patients with retroperitoneal sarcomas, as seen both in the randomized study from the NCI [53] and in other single-institution studies in the United States [56][57][58] and Europe [59,60]. On the basis of the NCI randomized trial, however, the use of adjuvant EBRT without IORT after marginal resection could be questioned because the same rate (80%) of tumour bed relapse has been observed in both the arms of adjuvant EBRT and surgery alone.…”

Section: Retroperitoneal and Pelvic Soft Tissue Sarcomasmentioning

confidence: 99%

Intraoperative radiation therapy

Meiriño

Orecchia

2006

Critical Reviews in Oncology/Hematology

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Section: Retroperitoneal and Pelvic Soft Tissue Sarcomasmentioning

confidence: 99%

Intraoperative radiation therapy

Meiriño

Orecchia

2006

Critical Reviews in Oncology/Hematology

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“…Brachytherapy is an alternative for delivering local tumour-bed boosts. In this setting, it has typically been combined with the standard doses of preoperative EBRT [64][65][66][67][68].…”

Section: What Is the Role Of Radiotherapy In Treating Retroperitonealmentioning

confidence: 99%

Multidisciplinary management of soft tissue sarcomas

2010

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Musculoskeletal sarcomas are a heterogeneous group of malignant neoplasms derived from connective tissue. Sarcomas represent about 1% of cancer in adults. The annual incidence in adults in Europe is around 14,000 new cases of soft tissue sarcomas (STS) and 4,800 new cases of bone sarcomas. Musculoskeletal tumours arise anywhere in the body, although lower extremities are the most common site of appearance, followed by upper extremities, trunk, retroperitoneum and head and neck area. Adequate management of STS is a stimulating challenge for oncologists. The aim of treatment should be focused on four main aspects: improving survival, avoiding local recurrence, maximising organ function and, finally, minimising morbidity. Surgery, radiotherapy and, sometimes though increasingly, chemotherapy are the pillars on which rests the modern treatment of sarcomas. The optimal management of musculoskeletal tumour requires a multidisciplinary integration of these different approaches in treatment planning right from the initial diagnoses. Referring patients to qualified centres should be desirable to achieve the maximum probability of control and even cure for STS.

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“…Additionally, difficulties in the identification and delineation of the area requiring radiation after radical render administration of the desired, full radiation dose impossible (2,12,13,14).…”

mentioning

confidence: 99%

“…Promising results have been published regarding the use of intraoperative brachytherapy and intraoperative teleradiotherapy following radical excision of the sarcoma, usually in combination with perioperative teleradiotherapy (7,14,(16)(17)(18)(19)(20).…”

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confidence: 99%

Value of Combined Treatment of Retroperitoneal Sarcomas

Kamiński

Kołosza

Strojek

et al. 2007

Polish Journal of Surgery

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The aim of the study was to determine treatment results in patients with retroperitoneal sarcomas, especially as respects the value of combined therapy. Material and methods. The study group included 37 patients with retroperitoneal sarcomas who underwent treatment at the Department of Oncological Surgery, Oncology Center in Gliwice during the period between 1992 and 2005. The study group included 25 women and 12 men, aged between 21 and 68 years (mean age -56.2 years). Adjuvant therapy after the operation was performed in the case of 15 patients. Nine received adjuvant teleradiotherapy (RT) at an average dose of 47.5 Gy (one patient after a non-resective procedure). Four received intraoperative brachytherapy (BT) at a dose of 15.8 Gy in combination with postoperative teleradiotherapy at a dose of 39 Gy. One patient was subjected to intraoperative brachytherapy. One female patient received adjuvant chemotherapy (Iphosphamid + Adriamycin). Results. The cumulative five-year total survival period of the analysed group was 40.7% according to Kaplan-Meier's method. Twenty patients died and four were diagnosed with recurrence, while 13 continue to live without recurrence. The type of resection had a significant effect on total survival (p=0.013): the five-year survival after radical procedures was 52.1%. We observed no five-year survivals after nonradical procedures. In order to determine the efficacy of combined treatment, patients who underwent to radical therapy were divided into three groups: patients without adjuvant therapy (group 1: 22 patients, 62.9%), patients subjected to adjuvant RT and BT therapy after the primary operation (group II: 5 patients, 14.25%), and patients who underwent the above-mentioned treatments after surgery, due to recurrence (group III: 8 patients, 22.85%). The total five-year survival in group I was 34.8%, in group II, 80%, and in group III, 72.9%. These differences were statistically insignificant (p=0.440). These results were probably influenced by the small number of patients, considering particular groups. Conclusions. 1. The most important prognostic factor in the treatment of retroperitoneal sarcomas is surgical margine type surgical margin. 2. Adjuvant radiotherapy, especially in combination with intraoperative brachytherapy, seems to be a promising method for the management of retroperitoneal sarcomas, and improves treatment results. 3. Treatment of retroperitoneal sarcomas should be undertaken in specialized centers adequately prepared for combined therapy. Key words: retroperitoneal sarcomas, adjuvant radiotherapy, intraoperative brachytherapy, combined therapy of neoplasms POLSKI PRZEGLĄD CHIRURGICZNY 10.2478/v10035-007-0045-3 2007 Retroperitoneal sarcomas are rarely diagnosed and account for only 10-15% of all soft tissue sarcomas, which in turn constitute 1% of all malignant neoplasms. They most often develop after the age of 50 years, and occur with similar frequency in men and women. Based

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Surgical management of retroperitoneal sarcomas associated with external and intraoperative electron beam radiotherapy

Cited by 42 publications

References 33 publications

Intraoperative radiation therapy

Intraoperative radiation therapy

Multidisciplinary management of soft tissue sarcomas

Value of Combined Treatment of Retroperitoneal Sarcomas

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