RESULTS OF COMBINED TREATMENT PATIENTS WITH SOFT TISSUE SARCOMAS USING STEREOTACTIC ABLATIVE BODY RADIOTHERAPY

Abstract

Preoperative radiotherapy in patients with soft tissue sarcomas characterized by important advantages: high precision of dose delivery, reduction of tumour volume and implantation potential, induction of immunologic response. Postoperative radiotherapy associated with decreased complication rate, delivery of treatment to microscopic disease according to pathologic report. Combination of pre- and postoperative irradiation gives the opportunity to use best of both methods. The aim: analyses of feasibility and safety of radiotherapy protocol that combined pre- and postoperative radiotherapy in patients with soft tissues sarcomas of extremities. Materials and methods: from 06.2018 to 01.2020 ten patients with soft tissue sarcomas of extremities were included in the protocol. Preoperative stereotactic ablative body radiotherapy (SABR) was performed as 5 fraction of 7 Gy on the main tumor volume with dose reduction to 5Gy in 5 fraction on the margins of the field. Postoperative radiotherapy started 5-8 weeks after surgery and was performed as standard compartmental irradiation in 25 fractions of 2Gy. Complications were determined according to CTCAE and wound complication scales. Results: from 06.2018 to 01.2020 10 patients with soft tissue sarcomas of extremities were included in the study. Pre-opeartive SABR and subsequent radical resection with tumor free surgical margins were performed in all 10 cases. Primary wound closure was mentioned in all patients. With relatively short follow-up of 9.1 (3-20) months we didn’t mentioned any case of grade II or more toxicity and no local recurrences. Conclusion: Our preliminary results demonstrate that combination of preoperative SABR and postoperative conventional radiotherapy is feasible and associated with low probability of grade II (and higher) toxicity.