High-dose pre-operative helical tomotherapy (54 Gy) for retroperitoneal liposarcoma

Radiation Oncology

Guy Kantor³  Eberhard Stoeckle⁴  Antoine Italiano¹  Binh Nguyen Bui¹  Véronique Brouste²  Bénédicte Henriques de Figueiredo³  Catherine Dejean⁵  Paul Sargos³ 

[1] Department of Medical Oncology, Institut Bergonié, Bordeaux, France;Clinical and Epidemiological Research Unit, Institut Bergonié, Bordeaux, France;Université Bordeaux Segalen, 229 cours de l’Argonne, Bordeaux 33076, France;Department of Surgery, Institut Bergonié, Bordeaux, France;Department of Radiation Oncology, Institut Bergonié, Bordeaux, France

关键词: Surgery;    Intensity modulated radiotherapy;    Helical tomotherapy;    Pre-operative radiotherapy;    Liposarcoma;    Retroperitoneal sarcoma;   

Others  :  1154906
DOI  :  10.1186/1748-717X-7-214

 received in 2012-07-17, accepted in 2012-12-12,  发布年份 2012

【 摘 要 】

Purpose

To evaluate the feasibility of pre-operative radiotherapy (54 Gy) with Helical Tomotherapy (HT) followed by surgery.

Methods and materials

Ten patients with non-metastatic resectable retroperitoneal liposarcomas were treated by pre-operative tomotherapy (54 Gy) and surgery. Clinical and biological toxicities were evaluated on the CTCAEV3.0 scale. For nine patients, delivered tomotherapy plans were compared with retrospectively-planned dynamic intensity-modulated radiotherapy (IMRT) dosimetric studies.

Results

No immediate or late Grade>2 toxicities were observed after radiotherapy. Post-operatively, one patient died and three patients experienced Grade 3 toxicity (two digestive and one metabolic). These toxicities disappeared and only two patients presented persistent Grade 1 paresthesia. R0 resection was obtained for four patients, R1 for four, and R2 resection for two. With a median follow-up of 26 months, no local or metastatic relapse was observed. Dosimetric comparisons between HT and retrospectively-planned IMRT demonstrate adequate target volume coverage for both techniques. Gastrointestinal sparing is higher with HT with a D200cc reduced by 5 Gy. Integral dose (ID) was increased in HT.

Conclusions

High dose pre-operative radiotherapy (54 Gy) for retroperitoneal liposarcoma is feasible and mostly well tolerated. Cumulative toxicity and tolerance depend mainly on patient’s general status. Image-guided radiation therapy (IGRT) is essential, irrespective of the IMRT technique used. Furthermore, HT offers the possibility of sparing selected areas in such complex volumes.

【 授权许可】

   
2012 Sargos et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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