Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series
Purpose: Optimal treatment of retroperitoneal sarcoma (RPS) remains undefined. Here, we report the feasibility of using high-dose boost radiation (3-4 Gy) to the central part of the tumor in patients with unresectable RPS. Methods and Materials: Five patients with unresectable RPS were treated with...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109424002525 |
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| author | Danielle N. Burner, BS Peter G. Hendrickson, MD, PhD Diana M. Cardona, MD Dan G. Blazer, III, MD James B. Mullins, CMD David G. Kirsch, MD, PhD |
| author_facet | Danielle N. Burner, BS Peter G. Hendrickson, MD, PhD Diana M. Cardona, MD Dan G. Blazer, III, MD James B. Mullins, CMD David G. Kirsch, MD, PhD |
| author_sort | Danielle N. Burner, BS |
| collection | DOAJ |
| description | Purpose: Optimal treatment of retroperitoneal sarcoma (RPS) remains undefined. Here, we report the feasibility of using high-dose boost radiation (3-4 Gy) to the central part of the tumor in patients with unresectable RPS. Methods and Materials: Five patients with unresectable RPS were treated with radiation therapy using a central boost technique with intensity modulated radiation therapy. On average, doses of 25 Gy to 45 Gy were delivered to the outer part of the tumor (planning target volume 1), while the central part of the tumor (planning target volume 2) received a 56 Gy to 75 Gy physical dose, which translates to a 62.67 Gy to 87.5 Gy equivalent dose in 2 Gy fractions (EQD2). To minimize radiation toxicity to the adjacent bowel and other organs, we used sequential, interdigitated, or simultaneous integrated boost (SIB) techniques. Results: In this case series of variable RPS histology, the median survival postradiation therapy was 30 months. Three of the 5 patients had clinically stable local disease on follow-up scans, and none of the patients experienced clinically significant toxicity. Conclusions: In summary, in this small case series of 5 patients, treatment was tolerated well, and excellent local responses were observed regardless of the timing of the central boost. Given the high rates of metastatic disease that developed in responding patients, effective systemic therapy will likely be needed for unresectable RPS treated with aggressive radiation therapy to the central part of the tumor. |
| format | Article |
| id | doaj-art-c362136a7dd14b3d9beb004b17bfdcaa |
| institution | OA Journals |
| issn | 2452-1094 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj-art-c362136a7dd14b3d9beb004b17bfdcaa2025-08-20T02:00:12ZengElsevierAdvances in Radiation Oncology2452-10942025-02-0110210168910.1016/j.adro.2024.101689Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case SeriesDanielle N. Burner, BS0Peter G. Hendrickson, MD, PhD1Diana M. Cardona, MD2Dan G. Blazer, III, MD3James B. Mullins, CMD4David G. Kirsch, MD, PhD5Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North CarolinaDepartment of Radiation Oncology, Duke University Medical Center, Durham, North CarolinaDepartment of Pathology, Duke University Medical Center, Durham, North CarolinaDepartment of Surgery, Duke University Medical Center, Durham, North CarolinaDepartment of Radiation Oncology, Duke University Medical Center, Durham, North CarolinaDepartment of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina; Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Corresponding author: David G. Kirsch, MD, PhDPurpose: Optimal treatment of retroperitoneal sarcoma (RPS) remains undefined. Here, we report the feasibility of using high-dose boost radiation (3-4 Gy) to the central part of the tumor in patients with unresectable RPS. Methods and Materials: Five patients with unresectable RPS were treated with radiation therapy using a central boost technique with intensity modulated radiation therapy. On average, doses of 25 Gy to 45 Gy were delivered to the outer part of the tumor (planning target volume 1), while the central part of the tumor (planning target volume 2) received a 56 Gy to 75 Gy physical dose, which translates to a 62.67 Gy to 87.5 Gy equivalent dose in 2 Gy fractions (EQD2). To minimize radiation toxicity to the adjacent bowel and other organs, we used sequential, interdigitated, or simultaneous integrated boost (SIB) techniques. Results: In this case series of variable RPS histology, the median survival postradiation therapy was 30 months. Three of the 5 patients had clinically stable local disease on follow-up scans, and none of the patients experienced clinically significant toxicity. Conclusions: In summary, in this small case series of 5 patients, treatment was tolerated well, and excellent local responses were observed regardless of the timing of the central boost. Given the high rates of metastatic disease that developed in responding patients, effective systemic therapy will likely be needed for unresectable RPS treated with aggressive radiation therapy to the central part of the tumor.http://www.sciencedirect.com/science/article/pii/S2452109424002525 |
| spellingShingle | Danielle N. Burner, BS Peter G. Hendrickson, MD, PhD Diana M. Cardona, MD Dan G. Blazer, III, MD James B. Mullins, CMD David G. Kirsch, MD, PhD Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series Advances in Radiation Oncology |
| title | Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series |
| title_full | Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series |
| title_fullStr | Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series |
| title_full_unstemmed | Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series |
| title_short | Response to Central Boost Radiation Therapy in Unresectable Retroperitoneal Sarcoma: A Case Series |
| title_sort | response to central boost radiation therapy in unresectable retroperitoneal sarcoma a case series |
| url | http://www.sciencedirect.com/science/article/pii/S2452109424002525 |
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