O'Sullivan (2013) — Phase 2 study of preoperative image‐guided intensity‐modulated radiation therapy to reduce wound and combined modality morbidities in lower extremity soft tissue sarcoma

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only

O'Sullivan, Bell·Cancer·2013·248 citations·Oncology

No article notes available at this time.

Key Findings

Wound complications occurred in 18 of 59 patients (30.5%), numerically lower than the 43% rate from the NCIC SR2 trial, but the difference did not reach statistical significance (P = .2).
Primary wound closure was achieved significantly more often with IG-IMRT: 55 of 59 patients (93.2%) versus 50 of 70 patients (71.4%) in the historical comparison (P = .002).
Secondary operations for wound complications were numerically lower but not statistically significant: 6 of 18 patients (33%) versus 13 of 30 patients (43%) (P = .55).
Chronic toxicities were modest:
–Moderate edema in 6 patients (11.1%)
–Skin toxicity in 1 (1.9%)
–Subcutaneous toxicity in 5 (9.3%)
–Joint toxicity in 3 (5.6%); no bone fractures occurred.
Four local recurrences (6.8%) were observed at median follow-up of 49 months, none near the surgical flaps.

Clinical Relevance

• Wound healing complications are a major source of morbidity after preoperative radiation for extremity sarcoma, and this study provides prospective data on whether IMRT's improved normal-tissue sparing translates into fewer wound problems. • The significant increase in primary wound closure (avoiding tissue transfer) is a practically meaningful finding for surgical planning, even though the overall wound complication rate did not differ significantly from historical controls. • The absence of fractures and low rates of chronic edema/joint toxicity support IMRT's normal-tissue-sparing rationale, informing discussions with patients about long-term functional trade-offs of preoperative radiation.

Core

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue Sarcoma|Citation only

Key Findings

Clinical Relevance

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue Sarcoma|Citation only

Key Findings

Clinical Relevance

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue Sarcoma|Citation only

Key Findings

Clinical Relevance

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue Sarcoma|Citation only

Key Findings

Clinical Relevance

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only

Phase 2 Study of Preoperative Image‐guided Intensity‐modulated Radiation Therapy to Reduce Wound and Combined Modality Morbidities in Lower Extremity Soft Tissue SarcomaCitation only