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01.10.2014 | Radiotherapy

Radiation therapy for retroperitoneal sarcoma

verfasst von: Jeffrey Tuan, Viviana Vitolo, Barbara Vischioni, Alberto Iannalfi, Maria Rosaria Fiore, Piero Fossati, Roberto Orecchia

Erschienen in: La radiologia medica | Ausgabe 10/2014

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Abstract

Purpose

Retroperitoneal sarcomas (RPS) are rare tumours with an annual reported incidence of 2.7 per million persons. In spite of improvements in both diagnostic imaging and therapeutic strategies, patients afflicted by RPS still have poor prognoses. There are currently many different therapeutic strategies for these rare tumours and combining several different multi-modality strategies have not proved to have superior long-term clinical results. This review analyses the available published data and discusses multi-modality management of this rare entity. In particular, the role of radiation therapy, treatment-related side effects and the use of modern radiation treatment techniques will be discussed.

Materials and methods

A comprehensive literature search was conducted using PubMed in January 2011. Relevant international articles published from January 1980 to January 2011 were assessed. The keywords for search purposes were: retroperitoneum, sarcoma, radiotherapy, and radiation therapy. The search was limited to articles published in English. All articles were read in full by the authors and selected for inclusion based on relevance to this article.

Conclusions

The addition of radiation therapy (RT) to wide surgical excision for RPS has improved local control rates when compared with surgery alone. Preoperative RT is preferred over postoperative RT. New types and delivery techniques in radiation therapy could further improve patient outcomes. Emerging therapies that employ charged particles (such as protons and carbon ions) are expected to be superior in sparing of normal tissues and efficacy over conventional photon therapy radiation, due to their physical and radiobiological properties.

Strauss DC, Hayes AJ, Thomas JM (2011) Retroperitoneal tumours: review of management. Ann R Coll Surg Engl 93:275–280PubMedCrossRefPubMedCentral

Porter GA, Baxter NN, Pisters PW (2006) Retroperitoneal sarcoma: a population-based analysis of epidemiology, surgery, and radiotherapy. Cancer 106:1610–1616PubMedCrossRef

Roberge D, Vakilian S, Alabed YZ et al (2012) FDG PET/CT in initial staging of adult soft-tissue sarcoma. Sarcoma 2012:960194PubMedCrossRefPubMedCentral

Perez EA, Gutierrez JC, Moffat FL Jr et al (2007) Retroperitoneal and truncal sarcomas: prognosis depends upon type not location. Ann Surg Oncol 14:1114–1122PubMedCrossRef

Stoeckle E, Coindre JM, Bonvalot S et al (2001) Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer 92:359–368PubMedCrossRef

Van De Voorde L, Delrue L, van Eijkeren M, De Meerleer G (2011) Radiotherapy and surgery—an indispensable duo in the treatment of retroperitoneal sarcoma. Cancer 117:4355–4364CrossRef

Le Pechoux C, Musat E, Baey C et al (2013) Should adjuvant radiotherapy be administered in addition to front-line aggressive surgery (FAS) in patients with primary retroperitoneal sarcoma? Ann Oncol 24:832–837PubMedCrossRef

Ballo MT, Zagars GK, Pollock RE et al (2007) Retroperitoneal soft tissue sarcoma: an analysis of radiation and surgical treatment. Int J Radiat Oncol Biol Phys 67:158–163PubMedCrossRef

Alford S, Choong P, Chander S et al (2013) Outcomes of preoperative radiotherapy and resection of retroperitoneal sarcoma. ANZ J Surg 83:336–341PubMedCrossRef

10.

Lee HJ, Song SY, Kwon TW et al (2011) Treatment outcome of postoperative radiotherapy for retroperitoneal sarcoma. Radiat Oncol J 29:260–268PubMedCrossRefPubMedCentral

11.

Serizawa I, Kagei K, Kamada T et al (2009) Carbon ion radiotherapy for unresectable retroperitoneal sarcomas. Int J Radiat Oncol Biol Phys 75:1105–1110PubMedCrossRef

12.

Bonvalot S, Cavalcanti A, Le Pechoux C et al (2005) Randomized trial of cytoreduction followed by intraperitoneal chemotherapy versus cytoreduction alone in patients with peritoneal sarcomatosis. Eur J Surg Oncol 31:917–923PubMedCrossRef

13.

Bossi A, De Wever I, Van Limbergen E, Vanstraelen B (2007) Intensity-modulated radiation therapy for preoperative posterior abdominal wall irradiation of retroperitoneal liposarcomas. Int J Radiat Oncol Biol Phys 67:164–170PubMedCrossRef

14.

Pisters PW, Ballo MT, Fenstermacher MJ et al (2003) Phase I trial of preoperative concurrent doxorubicin and radiation therapy, surgical resection, and intraoperative electron-beam radiation therapy for patients with localized retroperitoneal sarcoma. J Clin Oncol 21:3092–3097PubMedCrossRef

15.

Willett CG, Suit HD, Tepper JE et al (1991) Intraoperative electron beam radiation therapy for retroperitoneal soft tissue sarcoma. Cancer 68:278–283PubMedCrossRef

16.

Petersen IA, Haddock MG, Donohue JH et al (2002) Use of intraoperative electron beam radiotherapy in the management of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys 52:469–475PubMedCrossRef

17.

Bobin JY, Al-Lawati T, Granero LE et al (2003) Surgical management of retroperitoneal sarcomas associated with external and intraoperative electron beam radiotherapy. Eur J Surg Oncol 29:676–681PubMedCrossRef

18.

Gieschen HL, Spiro IJ, Suit HD et al (2001) Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 50:127–131PubMedCrossRef

19.

Pawlik TM, Pisters PW, Mikula L et al (2006) Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma. Ann Surg Oncol 13:508–517PubMedCrossRef

20.

Sindelar WF, Kinsella TJ, Chen PW et al (1993) Intraoperative radiotherapy in retroperitoneal sarcomas. Final results of a prospective, randomized, clinical trial. Arch Surg 128:402–410PubMedCrossRef

21.

Krempien R, Roeder F, Oertel S et al (2006) Intraoperative electron-beam therapy for primary and recurrent retroperitoneal soft-tissue sarcoma. Int J Radiat Oncol Biol Phys 65:773–779PubMedCrossRef

22.

Shaw EG, Gunderson LL, Martin JK et al (1990) Peripheral nerve and ureteral tolerance to intraoperative radiation therapy: clinical and dose–response analysis. Radiother Oncol 18:247–255PubMedCrossRef

23.

Catton CN, O’Sullivan B, Kotwall C et al (1994) Outcome and prognosis in retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 29:1005–1010PubMedCrossRef

24.

Tepper JE, Suit HD, Wood WC et al (1984) Radiation therapy of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys 10:825–830PubMedCrossRef

25.

Fein DA, Corn BW, Lanciano RM et al (1995) Management of retroperitoneal sarcomas: does dose escalation impact on locoregional control? Int J Radiat Oncol Biol Phys 31:129–134PubMedCrossRef

26.

Pisters PW, O’Sullivan B, Maki RG (2007) Evidence-based recommendations for local therapy for soft tissue sarcomas. J Clin Oncol 25:1003–1008PubMedCrossRef

27.

Yang JC, Chang AE, Baker AR et al (1998) Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 16:197–203PubMed

28.

O’Sullivan B, Davis AM, Turcotte R et al (2002) Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 359:2235–2241PubMedCrossRef

29.

Emami B, Lyman J, Brown A et al (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109–122PubMedCrossRef

30.

Zlotecki RA, Katz TS, Morris CG et al (2005) Adjuvant radiation therapy for resectable retroperitoneal soft tissue sarcoma: the University of Florida experience. Am J Clin Oncol 28:310–316PubMedCrossRef

31.

Jones JJ, Catton CN, O’Sullivan B et al (2002) Initial results of a trial of preoperative external-beam radiation therapy and postoperative brachytherapy for retroperitoneal sarcoma. Ann Surg Oncol 9:346–354PubMedCrossRef

32.

Gilbeau L, Kantor G, Stoeckle E et al (2002) Surgical resection and radiotherapy for primary retroperitoneal soft tissue sarcoma. Radiother Oncol 65:137–143PubMedCrossRef

33.

Alektiar KM, Hu K, Anderson L et al (2000) High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas. Int J Radiat Oncol Biol Phys 47:157–163PubMedCrossRef

34.

Kepka L, DeLaney TF, Suit HD, Goldberg SI (2005) Results of radiation therapy for unresected soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 63:852–859PubMedCrossRef

35.

Paumier A, Le Pechoux C, Beaudre A et al (2011) IMRT or conformal radiotherapy for adjuvant treatment of retroperitoneal sarcoma? Radiother Oncol 99:73–78PubMedCrossRef

36.

Heslin MJ, Lewis JJ, Nadler E et al (1997) Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management. J Clin Oncol 15:2832–2839PubMed

37.

Swanson EL, Indelicato DJ, Louis D et al (2012) Comparison of three-dimensional (3D) conformal proton radiotherapy (RT), 3D conformal photon RT, and intensity-modulated RT for retroperitoneal and intra-abdominal sarcomas. Int J Radiat Oncol Biol Phys 83:1549–1557PubMedCrossRef

38.

Yoon SS, Chen YL, Kirsch DG et al (2010) Proton-beam, intensity-modulated, and/or intraoperative electron radiation therapy combined with aggressive anterior surgical resection for retroperitoneal sarcomas. Ann Surg Oncol 17:1515–1529PubMedCrossRefPubMedCentral

39.

Schmitt G, Mills EE, Levin V et al (1989) The role of neutrons in the treatment of soft tissue sarcomas. Cancer 64:2064–2068PubMedCrossRef

40.

Schonekaes KG, Prott FJ, Micke O et al (1999) Radiotherapy on adult patients with soft tissue sarcoma with fast neutrons or photons. Anticancer Res 19:2355–2359PubMed

41.

Schwartz DL, Einck J, Bellon J, Laramore GE (2001) Fast neutron radiotherapy for soft tissue and cartilaginous sarcomas at high risk for local recurrence. Int J Radiat Oncol Biol Phys 50:449–456PubMedCrossRef

42.

Kamada T, Tsujii H, Tsuji H et al (2002) Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas. J Clin Oncol 20:4466–4471PubMedCrossRef

43.

Imai R, Kamada T, Tsuji H et al (2010) Effect of carbon ion radiotherapy for sacral chordoma: results of Phase I–II and Phase II clinical trials. Int J Radiat Oncol Biol Phys 77:1470–1476PubMedCrossRef

44.

Imai R, Kamada T, Tsuji H et al (2004) Carbon ion radiotherapy for unresectable sacral chordomas. Clin Cancer Res 10:5741–5746PubMedCrossRef

45.

Kanai T, Matsufuji N, Miyamoto T et al (2006) Examination of GyE system for HIMAC carbon therapy. Int J Radiat Oncol Biol Phys 64:650–656PubMedCrossRef

46.

Lewis JJ, Leung D, Woodruff JM, Brennan MF (1998) Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 228:355–365PubMedCrossRefPubMedCentral

47.

Youssef E, Fontanesi J, Mott M et al (2002) Long-term outcome of combined modality therapy in retroperitoneal and deep-trunk soft-tissue sarcoma: analysis of prognostic factors. Int J Radiat Oncol Biol Phys 54:514–519PubMedCrossRef

48.

Gronchi A, Casali PG, Fiore M et al (2004) Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution. Cancer 100:2448–2455PubMedCrossRef

49.

Pierie JP, Betensky RA, Choudry U et al (2006) Outcomes in a series of 103 retroperitoneal sarcomas. Eur J Surg Oncol 32:1235–1241PubMedCrossRef

50.

Dziewirski W, Rutkowski P, Nowecki ZI et al (2006) Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas. Ann Surg Oncol 13:245–252PubMedCrossRef

51.

Tzeng CW, Fiveash JB, Popple RA et al (2006) Preoperative radiation therapy with selective dose escalation to the margin at risk for retroperitoneal sarcoma. Cancer 107:371–379PubMedCrossRef

52.

van Dalen T, Plooij JM, van Coevorden F et al (2007) Long-term prognosis of primary retroperitoneal soft tissue sarcoma. Eur J Surg Oncol 33:234–238PubMedCrossRef

53.

White JS, Biberdorf D, DiFrancesco LM et al (2007) Use of tissue expanders and pre-operative external beam radiotherapy in the treatment of retroperitoneal sarcoma. Ann Surg Oncol 14:583–590PubMedCrossRef

54.

Caudle AS, Tepper JE, Calvo BF et al (2007) Complications associated with neoadjuvant radiotherapy in the multidisciplinary treatment of retroperitoneal sarcomas. Ann Surg Oncol 14:577–582PubMedCrossRef

Titel: Radiation therapy for retroperitoneal sarcoma
verfasst von: Jeffrey Tuan
Viviana Vitolo
Barbara Vischioni
Alberto Iannalfi
Maria Rosaria Fiore
Piero Fossati
Roberto Orecchia
Publikationsdatum: 01.10.2014
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 10/2014
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-013-0350-3

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Radiation therapy for retroperitoneal sarcoma