Preoperative versus postoperative radiotherapy in soft tissue sarcomas: State of the art and perspectives

xlomafota13 shared this article with you from Inoreader Preoperative versus postoperative radiotherapy in soft tissue sarcomas: State of the art and perspectives Via Association française pour l'étude du cancer Bull Cancer. 2021 Jul 7:S0007-4551(21)00167-3. doi: 10.1016/j.bulcan.2021.03.012. Online ahead of print. ABSTRACT Radiation therapy is a standard treatment for limbs soft tissue sarcomas. Preoperative versus postoperative radiotherapy has been a controversial topic for years. With preoperative irradiation, the treatment volume is more limited, the delivered dose possibly lower and the tumor volume easier to delimit. Only one randomized trial compared these two irradiation sequences. The results in terms of local control and survival were equivalent but the risk of acute postoperative complications was higher if irradiation was administered before surgery. However, in the latest update of this trial, patients who received adjuvant irradiation exhibited more severe late toxicity than those treated preoperatively. In addition, with modern irradiation techniques such as conformal with image-guided intensity modulated radiotherapy and flap coverage techniques, the incidence of complications after preoperative irradiation were lower than historically published rates. Locally advanced proximal sarcomas and the failure of other neoadjuvant treatments are nowadays classical indications for preoperative irradiation. As with other neoadjuvant treatments, induction radiotherapy must be personalized according to the histological subtype, the tumor site and the benefit/risk ratio, which is best appreciated by a multidisciplinary surgical and oncological team in a specialized center in the management of soft-tissue sarcomas. PMID:34246458 | DOI:10.1016/j.bulca n.2021.03.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.