Efficacy of neoadjuvant hypofractionated radiotherapy in patients with locally advanced myxoid liposarcoma.

Abstract

BACKGROUND:

Myxoid liposarcoma (MLPS) has been reported to be more radiosensitive compared with other soft tissue sarcomas (STS). The use of preoperative hypofractionated radiotherapy 5 × 5 Gy for five consecutive days, and then immediate surgery in patients with locally advanced STS showed a good local control rate. The main objective of our work was to assess the efficacy of hypofractionated radiotherapy in preoperative setting in patients with locally advanced primary MLPS.

METHODS:

From February 1999 to March 2014, 32 patients with primary MLPS were treated with preoperative hypofractionated radiotherapy for 5 consecutive days followed by immediate surgery (median dose 5 × 5 Gy). Median size of the tumor 10.5 cm. In one patient the tumor was located on the upper extremity, the other (31 patients) had their tumors located on the lower extremity.

RESULTS:

In 90% patients histologically negative surgical margins (R0) were obtained. 34% patients had distant recurrence of the disease, local recurrence was found in 9.3% of the patients. 5-year local relapse-free survival rate was 90% and overall survival was 68%. In all analyzed surgical specimens the radiotherapy response features (hyalinization, fibrosis, paucicelularity, hemorrhages, dilatation of vessels) were detected. We have not found statistically significant differences in terms of OS and LRFS for RCC component, tumor grade, BCL2, TP53, postsurgery necrosis and tumor size. In postradiotherapy specimens significantly higher positivity of TP53 expression was detected as compared to primary biopsies.

CONCLUSION:

Combined therapy with hypofractionated radiotherapy followed by immediate surgery seems to be effective therapy in MLPS demonstrating good local control and pathological response to therapy.

• Authors: H Koseła-Paterczyk, A Szumera-Ciećkiewicz, M Szacht, R Haas, T Morysiński, W Dziewirski, M Prochorec-Sobieszek, P Rutkowski
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 42 Issue 6 Pg. 891-8 (Jun 2016) ISSN: 1532-2157 [Electronic] England
• PMID: 27026512 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Immunohistochemistry
• Kaplan-Meier Estimate
• Liposarcoma, Myxoid (mortality, pathology, radiotherapy, surgery)
• Male
• Medical Records
• Middle Aged
• Neoadjuvant Therapy (methods)
• Neoplasm Staging
• Poland
• Radiation Dose Hypofractionation
• Radiotherapy, Adjuvant (methods)
• Retrospective Studies
• Thigh (pathology, radiation effects, surgery)
• Treatment Outcome