Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial
Identifieur interne : 000677 ( Pmc/Corpus ); précédent : 000676; suivant : 000678Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial
Auteurs : Dian Wang ; Qiang Zhang ; Burton L. Eisenberg ; John M. Kane ; X. Allen Li ; David Lucas ; Ivy A. Petersen ; Thomas F. Delaney ; Carolyn R. Freeman ; Steven E. Finkelstein ; Ying J. Hitchcock ; Manpreet Bedi ; Anurag K. Singh ; George Dundas ; David G. KirschSource :
- Journal of Clinical Oncology [ 0732-183X ] ; 2015.
Abstract
We performed a multi-institutional prospective phase II trial to assess late toxicities in patients with extremity soft tissue sarcoma (STS) treated with preoperative image-guided radiation therapy (IGRT) to a reduced target volume.
Patients with extremity STS received IGRT with (cohort A) or without (cohort B) chemotherapy followed by limb-sparing resection. Daily pretreatment images were coregistered with digitally reconstructed radiographs so that the patient position could be adjusted before each treatment. All patients received IGRT to reduced tumor volumes according to strict protocol guidelines. Late toxicities were assessed at 2 years.
In all, 98 patients were accrued (cohort A, 12; cohort B, 86). Cohort A was closed prematurely because of poor accrual and is not reported. Seventy-nine eligible patients from cohort B form the basis of this report. At a median follow-up of 3.6 years, five patients did not have surgery because of disease progression. There were five local treatment failures, all of which were in field. Of the 57 patients assessed for late toxicities at 2 years, 10.5% experienced at least one grade ≥ 2 toxicity as compared with 37% of patients in the National Cancer Institute of Canada SR2 (CAN-NCIC-SR2: Phase III Randomized Study of Pre- vs Postoperative Radiotherapy in Curable Extremity Soft Tissue Sarcoma) trial receiving preoperative radiation therapy without IGRT (
The significant reduction of late toxicities in patients with extremity STS who were treated with preoperative IGRT and absence of marginal-field recurrences suggest that the target volumes used in the Radiation Therapy Oncology Group RTOG-0630 (A Phase II Trial of Image-Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity) study are appropriate for preoperative IGRT for extremity STS.
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DOI: 10.1200/JCO.2014.58.5828
PubMed: 25667281
PubMed Central: 4486342
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial</title><author><name sortKey="Wang, Dian" sort="Wang, Dian" uniqKey="Wang D" first="Dian" last="Wang">Dian Wang</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Zhang, Qiang" sort="Zhang, Qiang" uniqKey="Zhang Q" first="Qiang" last="Zhang">Qiang Zhang</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Eisenberg, Burton L" sort="Eisenberg, Burton L" uniqKey="Eisenberg B" first="Burton L." last="Eisenberg">Burton L. Eisenberg</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Kane, John M" sort="Kane, John M" uniqKey="Kane J" first="John M." last="Kane">John M. Kane</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Li, X Allen" sort="Li, X Allen" uniqKey="Li X" first="X. Allen" last="Li">X. Allen Li</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Lucas, David" sort="Lucas, David" uniqKey="Lucas D" first="David" last="Lucas">David Lucas</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Petersen, Ivy A" sort="Petersen, Ivy A" uniqKey="Petersen I" first="Ivy A." last="Petersen">Ivy A. Petersen</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Delaney, Thomas F" sort="Delaney, Thomas F" uniqKey="Delaney T" first="Thomas F." last="Delaney">Thomas F. Delaney</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Freeman, Carolyn R" sort="Freeman, Carolyn R" uniqKey="Freeman C" first="Carolyn R." last="Freeman">Carolyn R. Freeman</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Finkelstein, Steven E" sort="Finkelstein, Steven E" uniqKey="Finkelstein S" first="Steven E." last="Finkelstein">Steven E. Finkelstein</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Hitchcock, Ying J" sort="Hitchcock, Ying J" uniqKey="Hitchcock Y" first="Ying J." last="Hitchcock">Ying J. Hitchcock</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Bedi, Manpreet" sort="Bedi, Manpreet" uniqKey="Bedi M" first="Manpreet" last="Bedi">Manpreet Bedi</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Singh, Anurag K" sort="Singh, Anurag K" uniqKey="Singh A" first="Anurag K." last="Singh">Anurag K. Singh</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Dundas, George" sort="Dundas, George" uniqKey="Dundas G" first="George" last="Dundas">George Dundas</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Kirsch, David G" sort="Kirsch, David G" uniqKey="Kirsch D" first="David G." last="Kirsch">David G. Kirsch</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25667281</idno><idno type="pmc">4486342</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486342</idno><idno type="RBID">PMC:4486342</idno><idno type="doi">10.1200/JCO.2014.58.5828</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000677</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000677</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial</title><author><name sortKey="Wang, Dian" sort="Wang, Dian" uniqKey="Wang D" first="Dian" last="Wang">Dian Wang</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Zhang, Qiang" sort="Zhang, Qiang" uniqKey="Zhang Q" first="Qiang" last="Zhang">Qiang Zhang</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Eisenberg, Burton L" sort="Eisenberg, Burton L" uniqKey="Eisenberg B" first="Burton L." last="Eisenberg">Burton L. Eisenberg</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Kane, John M" sort="Kane, John M" uniqKey="Kane J" first="John M." last="Kane">John M. Kane</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Li, X Allen" sort="Li, X Allen" uniqKey="Li X" first="X. Allen" last="Li">X. Allen Li</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Lucas, David" sort="Lucas, David" uniqKey="Lucas D" first="David" last="Lucas">David Lucas</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Petersen, Ivy A" sort="Petersen, Ivy A" uniqKey="Petersen I" first="Ivy A." last="Petersen">Ivy A. Petersen</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Delaney, Thomas F" sort="Delaney, Thomas F" uniqKey="Delaney T" first="Thomas F." last="Delaney">Thomas F. Delaney</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Freeman, Carolyn R" sort="Freeman, Carolyn R" uniqKey="Freeman C" first="Carolyn R." last="Freeman">Carolyn R. Freeman</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Finkelstein, Steven E" sort="Finkelstein, Steven E" uniqKey="Finkelstein S" first="Steven E." last="Finkelstein">Steven E. Finkelstein</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Hitchcock, Ying J" sort="Hitchcock, Ying J" uniqKey="Hitchcock Y" first="Ying J." last="Hitchcock">Ying J. Hitchcock</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Bedi, Manpreet" sort="Bedi, Manpreet" uniqKey="Bedi M" first="Manpreet" last="Bedi">Manpreet Bedi</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Singh, Anurag K" sort="Singh, Anurag K" uniqKey="Singh A" first="Anurag K." last="Singh">Anurag K. Singh</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Dundas, George" sort="Dundas, George" uniqKey="Dundas G" first="George" last="Dundas">George Dundas</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author><author><name sortKey="Kirsch, David G" sort="Kirsch, David G" uniqKey="Kirsch D" first="David G." last="Kirsch">David G. Kirsch</name><affiliation><nlm:aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Clinical Oncology</title><idno type="ISSN">0732-183X</idno><idno type="eISSN">1527-7755</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>We performed a multi-institutional prospective phase II trial to assess late toxicities in patients with extremity soft tissue sarcoma (STS) treated with preoperative image-guided radiation therapy (IGRT) to a reduced target volume.</p></sec><sec><title>Patients and Methods</title><p>Patients with extremity STS received IGRT with (cohort A) or without (cohort B) chemotherapy followed by limb-sparing resection. Daily pretreatment images were coregistered with digitally reconstructed radiographs so that the patient position could be adjusted before each treatment. All patients received IGRT to reduced tumor volumes according to strict protocol guidelines. Late toxicities were assessed at 2 years.</p></sec><sec><title>Results</title><p>In all, 98 patients were accrued (cohort A, 12; cohort B, 86). Cohort A was closed prematurely because of poor accrual and is not reported. Seventy-nine eligible patients from cohort B form the basis of this report. At a median follow-up of 3.6 years, five patients did not have surgery because of disease progression. There were five local treatment failures, all of which were in field. Of the 57 patients assessed for late toxicities at 2 years, 10.5% experienced at least one grade ≥ 2 toxicity as compared with 37% of patients in the National Cancer Institute of Canada SR2 (CAN-NCIC-SR2: Phase III Randomized Study of Pre- vs Postoperative Radiotherapy in Curable Extremity Soft Tissue Sarcoma) trial receiving preoperative radiation therapy without IGRT (<italic>P</italic> < .001).</p></sec><sec><title>Conclusion</title><p>The significant reduction of late toxicities in patients with extremity STS who were treated with preoperative IGRT and absence of marginal-field recurrences suggest that the target volumes used in the Radiation Therapy Oncology Group RTOG-0630 (A Phase II Trial of Image-Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity) study are appropriate for preoperative IGRT for extremity STS.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Oncol</journal-id><journal-id journal-id-type="iso-abbrev">J. Clin. Oncol</journal-id><journal-id journal-id-type="hwp">jco</journal-id><journal-id journal-id-type="pmc">jco</journal-id><journal-id journal-id-type="publisher-id">JCO</journal-id><journal-title-group><journal-title>Journal of Clinical Oncology</journal-title></journal-title-group><issn pub-type="ppub">0732-183X</issn><issn pub-type="epub">1527-7755</issn><publisher><publisher-name>American Society of Clinical Oncology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25667281</article-id><article-id pub-id-type="pmc">4486342</article-id><article-id pub-id-type="publisher-id">85828</article-id><article-id pub-id-type="doi">10.1200/JCO.2014.58.5828</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>Radn</subject><subject>Sarc2</subject><subject>Sarc12</subject><subject>Sarc13</subject></subj-group><subj-group subj-group-type="heading"><subject>ORIGINAL REPORTS</subject><subj-group><subject>Rapid Communications</subject></subj-group></subj-group></article-categories><title-group><article-title>Significant Reduction of Late Toxicities in Patients With Extremity Sarcoma Treated With Image-Guided Radiation Therapy to a Reduced Target Volume: Results of Radiation Therapy Oncology Group RTOG-0630 Trial</article-title><alt-title alt-title-type="short">IGRT for Extremity STS</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Dian</given-names></name><xref ref-type="aff" rid="aff1"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Qiang</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Eisenberg</surname><given-names>Burton L.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Kane</surname><given-names>John M.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>X. Allen</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Lucas</surname><given-names>David</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Petersen</surname><given-names>Ivy A.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>DeLaney</surname><given-names>Thomas F.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Freeman</surname><given-names>Carolyn R.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Finkelstein</surname><given-names>Steven E.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Hitchcock</surname><given-names>Ying J.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Bedi</surname><given-names>Manpreet</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Singh</surname><given-names>Anurag K.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Dundas</surname><given-names>George</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Kirsch</surname><given-names>David G.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><aff id="aff1">Dian Wang, Rush University Medical Center, Chicago, IL; Qiang Zhang, NRG Oncology Statistics and Data Management Center, Philadelphia, PA; Burton L. Eisenberg, Hoag/University of Southern California Norris Cancer Center, Los Angeles, CA; John M. Kane and Anurag K. Singh, Roswell Park Cancer Institute, Buffalo, NY; X. Allen Li and Manpreet Bedi, Medical College of Wisconsin, Milwaukee, WI; David Lucas, University of Michigan, Ann Arbor, MI; Ivy A. Petersen, Mayo Clinic, Rochester, MN; Thomas F. DeLaney, Massachusetts General Hospital, Boston, MA; Carolyn R. Freeman, McGill University Health Centre, Montreal, Quebec; George Dundas, Cross Cancer Institute, Edmonton, Alberta, Canada; Steven E. Finkelstein, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ying J. Hitchcock, University of Utah, Salt Lake City, UT; and David G. Kirsch, Duke University Medical Center, Durham, NC.</aff></contrib-group><author-notes><corresp id="cor1">Corresponding author: Dian Wang, MD, Department of Radiation Oncology, Rush University Medical Center, 500 S. Paulina St, Atrium Building Ground Floor, Chicago, IL 60612; e-mail: <email>Dian_Wang@Rush.edu</email>.</corresp></author-notes><pub-date pub-type="ppub"><day>10</day><month>7</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>9</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>10</day><month>7</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 12 months and
0 days and was based on the
<volume>33</volume><issue>20</issue><fpage>2231</fpage><lpage>2238</lpage><permissions><copyright-statement>© 2015 by American Society of Clinical Oncology</copyright-statement><copyright-year>2015</copyright-year><copyright-holder>American Society of Clinical Oncology</copyright-holder></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zlj02015002231.pdf"></self-uri><abstract><sec><title>Purpose</title><p>We performed a multi-institutional prospective phase II trial to assess late toxicities in patients with extremity soft tissue sarcoma (STS) treated with preoperative image-guided radiation therapy (IGRT) to a reduced target volume.</p></sec><sec><title>Patients and Methods</title><p>Patients with extremity STS received IGRT with (cohort A) or without (cohort B) chemotherapy followed by limb-sparing resection. Daily pretreatment images were coregistered with digitally reconstructed radiographs so that the patient position could be adjusted before each treatment. All patients received IGRT to reduced tumor volumes according to strict protocol guidelines. Late toxicities were assessed at 2 years.</p></sec><sec><title>Results</title><p>In all, 98 patients were accrued (cohort A, 12; cohort B, 86). Cohort A was closed prematurely because of poor accrual and is not reported. Seventy-nine eligible patients from cohort B form the basis of this report. At a median follow-up of 3.6 years, five patients did not have surgery because of disease progression. There were five local treatment failures, all of which were in field. Of the 57 patients assessed for late toxicities at 2 years, 10.5% experienced at least one grade ≥ 2 toxicity as compared with 37% of patients in the National Cancer Institute of Canada SR2 (CAN-NCIC-SR2: Phase III Randomized Study of Pre- vs Postoperative Radiotherapy in Curable Extremity Soft Tissue Sarcoma) trial receiving preoperative radiation therapy without IGRT (<italic>P</italic> < .001).</p></sec><sec><title>Conclusion</title><p>The significant reduction of late toxicities in patients with extremity STS who were treated with preoperative IGRT and absence of marginal-field recurrences suggest that the target volumes used in the Radiation Therapy Oncology Group RTOG-0630 (A Phase II Trial of Image-Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity) study are appropriate for preoperative IGRT for extremity STS.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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