[Preoperative versus postoperative radiotherapy in soft tissue sarcomas: State of the art and perspectives]. / Radiothérapie préopératoire versus postopératoire dans les sarcomes des tissus mous : état des lieux et perspectives.
Bull Cancer
; 108(9): 868-876, 2021 Sep.
Article
em Fr
| MEDLINE
| ID: mdl-34246458
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.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias de Tecidos Moles
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Humans
Idioma:
Fr
Revista:
Bull Cancer
Ano de publicação:
2021
Tipo de documento:
Article