Aim: To evaluate measures of response to pre- operative radiotherapy (RT) for limb Soft Tissue Sarcoma (STS). Methods: Retrospective review of 20 sequential patients receiving limb RT for non- metastatic histologically proven STS from the local radiotherapy database. Response to preoperative RT was assessed using volume change on MRI and pathological percentage necrosis. Pathology retrospectively reviewed by 3 sarcoma pathologists for necrosis rate. All patients treated with standard dose and fractionation using either conventional or VMAT technique. Results: 11 myxoid liopsarcoma, 4 pleomorphic, 2 synovial, 2 spindle and 1 MPNST. Size range (longest dimension), 40 to 180mm. The range of change between pre and post-op MRI volumes was -665 mls to + 3213 mls. The pathological responses after RT ranged from 55 to 99%. Good inter-observer agreement for non myxoid liposarcoma, less agreement for myxoids. Conclusion: Pre operative RT did not consistently decrease tumour volume or induce significant pathological response. Differences between results from three pathologists reporting necrosis/ response warrant further investigation. Post operative complications after pre operative radiotherapy have been a local concern, however review of post operative complications has resulted in debate over scoring/ grading, rates of complications cannot be included until this is agreed locally. The overall benefit of pre operative RT has been questioned following a number of post operative complications. Pathology and radiology correlated fairly well as a marker of response, but less convincingly than expected. How can the risks and benefits for pre versus post operative radiotherapy be best evaluated to inform decision making?
|Publication status||Published - 27 Feb 2018|
|Event||British Sarcoma Group Annual Conference - The Repertory Theatre, Birmingham, United Kingdom|
Duration: 27 Feb 2018 → 28 Feb 2018
|Conference||British Sarcoma Group Annual Conference|
|Period||27/02/18 → 28/02/18|
- soft tissue sarcoma