The role of radiation therapy in the management of primary retroperitoneal sarcoma: A systematic review and clinical practice guidelines from the Australia and New Zealand Sarcoma Association

被引：2

作者：

Lawless, Anna ^{[1
,2
]}

Zhou, Deborah Di-Xin ^{[3
,4
]}

Mcdonough, Joshua ^{[5
]}

Lo, Helen ^{[6
]}

Mar, Jasmine ^{[7
]}

Lazarakis, Smaro ^{[8
]}

Ward, Iain ^{[9
]}

Connor, Joanna ^{[10
]}

Thompson, Stephen R. ^{[11
,12
]}

Coker, David ^{[1
,13
,14
]}

Johnston, Andrew ^{[15
]}

Gyorki, David E. ^{[16
,17
]}

Hong, Angela M. ^{[1
,2
]}

机构：

[1] Univ Sydney, Sydney Med Sch, Fac Med & Hlth, Sydney, Australia

[2] Chris OBrien Lifehouse, Dept Radiat Oncol, Camperdown, NSW 2050, Australia

[3] Univ Sydney, NHMRC Clin Trials Ctr, Sydney, NSW 2006, Australia

[4] Chris OBrien Lifehouse, Dept Med Oncol, Camperdown, NSW 2050, Australia

[5] Univ South Australia, Mental Hlth & Suicide Prevent Res & Educ Grp, Clin & Hlth Sci, Adelaide, SA 5000, Australia

[6] Chris OBrien Lifehouse, Dept Radiat Oncol, Camperdown, NSW 2050, Australia

[7] Australia & New Zealand Sarcoma Assoc, Parkville, Vic 3010, Australia

[8] Royal Melbourne Hosp, Hlth Sci Lib, Parkville, Vic 3010, Australia

[9] Christchurch Hosp, Christchurch 8011, New Zealand

[10] Auckland City Hosp, 2 Pk Rd, Auckland 1023, New Zealand

[11] Prince Wales Hosp, Nelune Comprehens Canc Ctr, Randwick, NSW 2031, Australia

[12] UNSW Sydney, Sch Clin Med, Randwick Clin Campus, Sydney, Australia

[13] Royal Prince Alfred Hosp, Dept Melanoma & Surg Oncol, Camperdown, NSW 2050, Australia

[14] Royal Prince Alfred Hosp, Upper Gastrointestinal Surg, Camperdown, NSW 2050, Australia

[15] Auckland City Hosp, North Isl Sarcoma Serv, Auckland 1023, New Zealand

[16] Peter MacCallum Canc Ctr, Div Canc Surg, Melbourne, Vic 3000, Australia

[17] Univ Melbourne, Sir Peter MacCallum Dept Oncol, Melbourne, Vic 3000, Australia

来源：

CANCER TREATMENT REVIEWS | 2023年 / 120卷

关键词：

Sarcoma; Retroperitoneal sarcoma; Radiotherapy; Liposarcoma; SOFT-TISSUE SARCOMA; SINGLE-INSTITUTION EVALUATION; PROGNOSTIC-FACTORS; PREOPERATIVE RADIATION; SURGICAL RESECTION; POSTOPERATIVE RADIOTHERAPY; ADJUVANT RADIOTHERAPY; SURVIVAL; OUTCOMES; SURGERY;

D O I：

10.1016/j.ctrv.2023.102620

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

While surgery is the mainstay of treatment for localised retroperitoneal sarcoma, the use of radiotherapy (RT) remains controversial. This systematic review aimed to evaluate the role of RT for retroperitoneal sarcoma.A systematic review using the population, intervention, comparison, and outcome model from 1990 to 2022 identified 66 studies (a mixture of preoperative and postoperative RT); one randomised controlled trial (RCT) with two publications, 18 registry studies, and 46 retrospective studies.In the RCT of preoperative RT, there was no difference in local/abdominal recurrence. The pooled analysis of this RCT and a retrospective study showed a significant abdominal recurrence free survival benefit with preoperative RT in low grade liposarcoma. The RCT and the majority of retrospective series found RT did not improve recurrence free survival (11 of 16 no difference in combined local and distant RFS, 11 of 13 no difference in distant metastasis free survival), disease specific survival (9 of 12 studies) or overall survival (33 of 49 studies). The majority of studies found no association between RT and perioperative morbidity.In summary, preoperative RT may improve local control for low grade (well-differentiated or grades 1-2 dedifferentiated) liposarcoma, but not other histological subtypes. There is no strong evidence that perioperative RT provides an overall survival benefit. Patients with low grade retroperitoneal liposarcoma can be considered for preoperative RT to improve abdominal recurrence free survival. The rationale and level of evidence in this scenario should be carefully discussed by the multidisciplinary team with patients. RT should not be routinely recommended for other histological subtypes.

引用

页数：9