Techniques to modulate radiotherapy toxicity and outcome in soft tissue sarcoma

Current Treatment Options in Oncology

Volumn 4, Issue 6, 2003, Pages 453-464

  O’Sullivan, Brian ^a   Ward, Iain ^b   Haycocks, Tara ^b   Sharpe, Michael ^b  

^a UNIVERSITY OF TORONTO   (Canada)

^b NONE

Author keywords

Gross Tumor Volume; Intensity Modulate Radiation Therapy; Radiat Oncol Biol Phys; Soft Tissue Sarcoma

Indexed keywords

CLINICAL TRIAL; COMPUTER ASSISTED RADIOTHERAPY; HUMAN; METHODOLOGY; MULTIMODALITY CANCER THERAPY; OUTCOME ASSESSMENT; RADIATION DOSE; RADIATION DOSE FRACTIONATION; RADIATION RESPONSE; RADIOTHERAPY; REVIEW; SARCOMA; TIME;

CLINICAL TRIALS; COMBINED MODALITY THERAPY; DOSE FRACTIONATION; DOSE-RESPONSE RELATIONSHIP, RADIATION; HUMANS; OUTCOME ASSESSMENT (HEALTH CARE); RADIOTHERAPY; RADIOTHERAPY DOSAGE; RADIOTHERAPY PLANNING, COMPUTER-ASSISTED; RADIOTHERAPY, CONFORMAL; SARCOMA; TIME FACTORS;

EID: 2342632620     PISSN: 15272729     EISSN: 15346277     Source Type: Journal    
DOI: 10.1007/s11864-003-0046-3     Document Type: Article

References (50)

1. Pisters PW, Harrison LB, Leung DH, et al.: Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996, 14:859–868. A landmark randomized trial indicating the benefit of adjuvant brachytherapy in the management of STS treated with conservative excision. A particularly positive methodologic issue is the use of intraoperative randomization to attempt to control randomization bias regarding the type of surgery to be performed.
2. Yang JC, Chang AE, Baker AR, et al.: Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998, 16:197–203. This is a landmark randomized trial indicating the benefits of adjuvant radiotherapy in the management of STS treated with conservative excision. This trial evaluated the more widely used external beam radiotherapy approach instead of brachytherapy.
3. O'Sullivan B, Wunder J, Pisters PW: Target description for radiotherapy of soft tissue sarcoma. In Clinical Target Volumes in Conformal Radiotherapy and Intensity Modulated Radiotherapy. Edited by Gregoire V, Scalliet P, Ang KK. Heidelberg: Springer; 2003:205–227. One of the only attempts to comprehensively describe target delineation in volumetric radiotherapy planning of STS.
4. O'Sullivan B, Davis AM, Turcotte R, et al.: Preoperative versus postoperative radiotherapy in soft tissue sarcoma of the limbs: a randomised trial. Lancet 2002, 359:2235–2241. The first landmark randomized prospective trial to address the controversy underlying the choice of preoperative versus post-operative radiotherapy in extremity STS. This trial is only the fourth randomized trial to address local management in this group of patients. It is the only multicenter study and it is the only source of prospective randomized data that addresses the issue of radiotherapy field parameters with real-time radiotherapy review. DOI: 10.1016/S0140-6736(02)09292-9
5. Panicek DM, Schwartz LH: Soft tissue edema around musculoskeletal sarcomas at magnetic resonance imaging. Sarcoma 1997, 1:189–191. DOI: 10.1080/13577149778308
6. O'Sullivan B, Wylie J, Catton C, et al.: The local management of soft tissue sarcoma. Semin Radiat Oncol 1999, 9:328–348. DOI: 10.1016/S1053-4296(99)80027-7
7. ICRU Report 50. Prescribing, Recording, and Reporting Photon Beam Therapy. Bethesda: International Commission on Radiation Units and Measurement; 1993.
8. ICRU Report 62. Prescribing, Recording, and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). Bethesda: International Commission on Radiation Units and Measurement; 1999.
9. Nielsen OS, Cummings B, O'Sullivan B, et al.: Preoperative and postoperative irradiation of soft tissue sarcomas: effect of radiation field size. Int J Radiat Oncol Biol Phys 1991, 21:1595–1599.
10. O'Sullivan B, Davis A: A randomized phase III trial of preoperative compared to postoperative radiotherapy in extremity soft tissue sarcoma.[abstract]. Int J Radiat Oncol Biol Phys 2001, 51(Suppl 1):151. DOI: 10.1016/S0360-3016(01)02098-3
11. Holt GE, Wunder JS, Griffin AM, et al.: Fractures following radiation therapy and limb salvage surgery for soft tissue sarcomas: high versus low dose radiotherapy. Proc Musculoskelet Tumor Soc 2002:41.
12. O'Sullivan B, Gullane P, Irish J, et al.: Preoperative radiotherapy for adult head and neck soft tissue sarcoma (STS): assessment of wound complication rates and cancer outcome in a prospective series. World J Surg 2003, 27:875–883. This report indicates that properly applied principles of sarcoma management result in acceptable outcome even in a traditionally adverse anatomic site for STS presentation, such as the head and neck. DOI: 10.1007/s00268-003-7115-4
13. Jones JJ, Catton CN, O’Sullivan B, et al.: Initial results of a trial of preoperative external beam radiation therapy and postoperative brachytherapy for retroperitoneal sarcoma. Ann Surg Oncol 2002, 9:346–354. Prospective pilot trial of preoperative radiotherapy, surgery, and postoperative brachytherapy from the Princess Margaret Hospital. The study had the unique advantage that toxicity of preoperative radiotherapy was separated prospectively from postoperative brachytherapy. Preoperative radiotherapy had a low toxicity profile, notwithstanding the large field sizes. DOI: 10.1007/BF02573869
14. Tepper J, Rosenberg SA, Glatstein E: Radiation therapy technique in soft tissue sarcomas of the extremity: policies of treatment at the National Cancer Institute. Int J Radiat Oncol Biol Phys 1982, 8:263–273.
15. Emami B, Graham MV, Michalski JM, et al.: Three-dimensional conformal radiation therapy: clinical aspects. In Principles and Practice of Radiation Oncology. Edited by Perez CA, Brady LW. Philadelphia: Lippincott-Raven; 1998:371–386.
16. Intensity-modulated radiotherapy: current status and issues of interest. IMRT Collaborative Working Group. Int J Radiat Oncol Biol Phys 2001, 51: 880-914. A paper by an expert working group that comprehensively outlines the field of IMRT and is especially useful for describing definitions and procedures needed for clinical and research protocols with this novel technology.
17. Ling CC, Humm J, Larson S, et al.: Towards multidimensional radiotherapy (MD-CRT): biological imaging and biological conformality. Int J Radiat Oncol Biol Phys 2000, 47:551–560. A unique paper outlining the potential to identify a biologic target volume to be conceived within the GTV based on imaging characteristics incorporating dose-painting techniques to achieve biologic conformality, in addition to traditional physical volume shaping. DOI: 10.1016/S0360-3016(00)00467-3
18. Kovacs G, Hebbinghaus D, Dennert P, et al.: Conformal treatment planning for interstitial brachytherapy. Strahlenther Onkol 1996, 172:469–474.
19. Suit H: The Gray lecture 2001: coming technical advances in radiation oncology. Int J Radiat Oncol Biol Phys 2002, 53:798–809. A detailed discussion of technologic gains in radiation oncology, with particular emphasis on proton beam by one of the foremost experts in the field. DOI: 10.1016/S0360-3016(02)02851-1
20. Ma CM, Pawlicki T, Lee MC, et al.: Energy- and intensity- modulated electron beams for radiotherapy. Phys Med Biol 2000, 45:2293–2311. Often forgotten amid the high interest given to photon and proton beam is the possibility of modulating the energy of electron beams and their intensity. This description of modulated electron therapy is promising for the treatment of superficial targets. Limitation of the depth of penetration and a consequent reduction in dose to tissues deeper to tumor is the attractive aspect of this capability. DOI: 10.1088/0031-9155/45/8/316
21. Gieschen HL, Spiro IJ, Suit HD, et al.: Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2001, 50:127–131. Long-term follow-up from the Massachusetts General Hospital (Boston, MA) on a series of patients with retroperitoneal sarcoma treated with preoperative radiotherapy surgery and intraoperative radiotherapy. DOI: 10.1016/S0360-3016(00)01589-3
22. Petersen IA, Haddock MG, Donohue JH, et al.: Use of intraoperative electron beam radiotherapy in the management of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2002, 52:469–475. The Mayo Clinic (Rochester, MN) experience with intraoperative radiotherapy and preoperative radiotherapy in retroperitoneal sarcoma. DOI: 10.1016/S0360-3016(01)02595-0
23. Stoeckle E, Coindre JM, Bonvalot S, et al.: Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer 2001, 92:359–368. DOI: 10.1002/1097-0142(20010715)92:2<359::AID-CNCR1331>3.0.CO;2-Y
24. Hong L, Alektiar K, Chui C, et al.: IMRT of large fields: whole-abdomen irradiation. Int J Radiat Oncol Biol Phys 2002, 54:278–289. This paper by the Memorial Sloan-Kettering (New York, NY) group highlights the technical challenges and opportunities provided by IMRT in treating complex large volumes with avoidance of critical structures, which is often needed in the treatment of intra-abdominal sarcomas. DOI: 10.1016/S0360-3016(02)02921-8
25. Coles CE, Twyman N, Earl HM, et al.: Conformal radio-therapy facilitates the delivery of concurrent chemo-therapy and radiotherapy: a case of primitive neuroectodermal tumour of the chest wall. Sarcoma 2000, 4:129–133. This paper makes the point that conformal techniques facilitate the delivery of concurrent radiotherapy and chemotherapy by significantly reducing the volume of bone marrow irradiated. The lack of acute and late toxicities is attributed to the optimal exclusion of normal tissues from the treatment field using these radiotherapy techniques. DOI: 10.1080/13577140020008101
26. DeLaney TF, Spiro IJ, Suit HD, et al.: Neoadjuvant chemotherapy and radiotherapy for large extremity soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2003, 56:1117–1127. DOI: 10.1016/S0360-3016(03)00186-X
27. Cormier JN, Patel SR, Herzog CE, et al.: Concurrent ifosfamide-based chemotherapy and irradiation: analysis of treatment-related toxicity in 43 patients with sarcoma. Cancer 2001, 92:1550–1555. DOI: 10.1002/1097-0142(20010915)92:6<1550::AID-CNCR1481>3.0.CO;2-C
28. O'Sullivan B, Bell R: Has “MAID” made it in the management of high-risk soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2003, 56:915–916. DOI: 10.1016/S0360-3016(03)00185-8
29. Robinson MH, Spruce L, Eeles R, et al.: Limb function following conservation treatment of adult soft tissue sarcoma. Eur J Cancer 1991, 27:1567–1574. DOI: 10.1016/0277-5379(91)90417-C
30. Stinson SF, DeLaney TF, Greenberg J, et al.: Acute and long-term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1991, 21:1493–1499.
31. Millar BM, Bragg CM, Conway J, et al.: Investigation of the use of intensity modulated radiotherapy (IMRT) in comparison with conformal radiotherapy in the management of soft tissue sarcoma.[abstract]. Int J Radiat Oncol Biol Phys 2001, 51(Suppl 1):412. DOI: 10.1016/S0360-3016(01)02582-2
32. Chan MF, Chui CS, Schupak K, et al.: The treatment of large extraskeletal chondrosarcoma of the leg: comparison of IMRT and conformal radiotherapy techniques. J Appl Clin Med Phys 2001, 2:3–8. The first paper to show the opportunity provided by IMRT to spare weight-bearing bone from the high-dose target area and lessen the risk of bone fracture. DOI: 10.1120/1.1322676
33. Hong L, Alektiar K, Hunt M, et al.: Intensity modulated radiotherapy for soft tissue sarcoma of thigh [abstract]. Int J Radiat Oncol Biol Phys 2002, 54:140–141. DOI: 10.1016/S0360-3016(02)03299-6
34. Graham JD, Robinson MH, Harmer CL: Re-irradiation of soft tissue sarcoma. Br J Radiol 1992, 65:157–161. DOI: 10.1259/0007-1285-65-770-157
35. Nori D, Schupak K, Shiu MH, et al.: Role of brachytherapy in recurrent extremity sarcoma in patients treated with prior surgery and irradiation. Int J Radiat Oncol Biol Phys 1991, 20:1229–1233.
36. Catton C, Davis A, Bell R, et al.: Soft tissue sarcoma of the extremity: limb salvage after failure of combined conservative therapy. Radiother Oncol 1996, 41:209–214. DOI: 10.1016/S0167-8140(96)01856-7
37. Pearlstone D, Janjan NA, Feig B, et al.: Re-resection with brachytherapy for locally recurrent soft tissue sarcoma arising in a previously irradiated field. Cancer J Sci Am 1999, 5:26–33.
38. Crownover RL, Marks KE: Adjuvant brachytherapy in the treatment of soft tissue sarcomas. Hematol Oncol Clin North Am 1999, 13:595–607. DOI: 10.1016/S0889-8588(05)70078-2
39. Milker-Zabel S, Zabel A, Thilmann C, et al.: Clinical results of retreatment of vertebral bone metastases by stereotactic conformal radiotherapy and intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys 2003, 55:162–167. DOI: 10.1016/S0360-3016(02)03864-6
40. Haycocks T, Kelly V, Islam M, et al.: High resolution intensity modulated radiation therapy (IMRT) for retroperitoneal soft tissue sarcoma (RPS) [abstract]. Sarcoma 2001, 5(Suppl 1):S24-S25.
41. Low DA: Quality assurance of intensity modulated radiotherapy. Semin Radiat Oncol 2002, 12:219–228. An important paper outlining the challenges presented for quality assurance in IMRT, an exceedingly complex method of radiotherapy planning and delivery. DOI: 10.1053/srao.2002.33700
42. Dixon P, O’Sullivan B: Radiotherapy quality assurance: time for everyone to take it seriously. Eur J Cancer 2003, 39:423–429. A recent comprehensive description of the need and scope of quality assurance for radiotherapy in the contemporary era. DOI: 10.1016/S0959-8049(02)00744-X
43. Purdy JA: Dose-volume specification: new challenges with intensity modulated radiation therapy. Semin Radiat Oncol 2002, 12:199–209. DOI: 10.1053/srao.2002.32432
44. Nishizawa K, Okunieff P, Elmaleh D, et al.: Blood flow of human soft tissue sarcomas measured by thallium-201 scanning: prediction of tumor response to radiation. Int J Radiat Oncol Biol Phys 1991, 20:593–597.
45. Nelson SJ: Multivoxel magnetic resonance spectroscopy of brain tumors. Mol Cancer Ther 2003, 2:497–507.
46. Sijens PE: Phosphorus MR spectroscopy in the treatment of human extremity sarcomas. NMR Biomed 1998, 11:341–353. DOI: 10.1002/(SICI)1099-1492(1998110)11:7<341::AID-NBM516>3.0.CO;2-U
47. Baudelet C, Gallez B: How does blood oxygen level-dependent (BOLD) contrast correlate with oxygen partial pressure (pO2) inside tumors? Magn Reson Med 2002, 48:980–986. DOI: 10.1002/mrm.10318
48. Jaffray DA, Siewerdsen JH, Wong JW, et al.: Flat-panel cone-beam computed tomography for image-guided radiation therapy. Int J Radiat Oncol Biol Phys 2002, 53:1337–1349. A timely paper outlining the strategy of using flat-panel cone-beam CT for image-guided radiation therapy, thus opening the door to new standards in the technical accuracy of radiotherapy delivery. DOI: 10.1016/S0360-3016(02)02884-5
49. Mackie TR, Kapatoes J, Ruchala K, et al.: Image guidance for precise conformal radiotherapy. Int J Radiat Oncol Biol Phys 2003, 56:89–105. A second important paper addressing the potential for unprecedented accuracy in radiotherapy delivery through on-line image guidance using helical tomotherapy. The technologies of helical tomotherapy and cone-beam CT represent competitive rival research platforms to achieve a similar goal. DOI: 10.1016/S0360-3016(03)00090-7
50. Borden EC, Baker LH, Bell RS, et al.: Soft tissue sarcomas of adults: state of the translational science. Clin Cancer Res 2003, 9:1941–1956. A recent paper outlining the current state of translational science in STS that includes specific recommendations for the development and performance of clinical protocols addressing new radiation treatment techniques to modulate toxicity and outcome in STS.