Sameed Hussain, Muhammad Imran Wajid, M. Omer, Muhammad Yousuf Khan, T. Maqsood, Adnan Zeb
{"title":"Pelvic lymph node recurrence in high-risk prostate cancer following prostate-only radiotherapy","authors":"Sameed Hussain, Muhammad Imran Wajid, M. Omer, Muhammad Yousuf Khan, T. Maqsood, Adnan Zeb","doi":"10.1017/S1460396921000649","DOIUrl":"https://doi.org/10.1017/S1460396921000649","url":null,"abstract":"Abstract Introduction: High-risk prostate cancer is the most common presentation at our institute among patients with non-metastatic prostate cancer. Traditionally, pelvic lymph nodes were given a prophylactic dose of radiotherapy while the prostate was given a curative dose of radiation. This study aims to evaluate patterns of failure in patients who had prostate-only radiation at our centre. Materials and Methods: All high-risk prostate cancer patients who underwent radical radiotherapy to prostate only since 2014 were retrospectively analysed. Local T stage, baseline prostate-specific antigen (PSA) and Gleason score were recorded. Bone scan and staging CT scan data were collected. Various dose levels prescribed to prostate were analysed. The follow-up records of these patients were assessed. Patients who failed in pelvic lymph nodes were recorded separately. Overall survival and failure-free survival were calculated using Kaplan–Meier curve. Results: One-hundred five patients fulfilling the inclusion criteria were analysed. Only three patients developed recurrence in pelvic lymph node following prostate-only radiotherapy (PORT). Five year overall survival was 77% while failure-free survival was 64%. Forty patients had a PSA failure after a median follow-up of 62 months. Conclusions: Most high-risk prostate cancer patients who progress following hormone therapy and PORT have metastases outside pelvis. Till further conclusive evidence is available PORT can be considered as a safe option.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43717390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A narrative review exploring the professional practice training requirement of therapeutic radiographers undertaking effective remote/telephone review clinics in place of face-to-face radiographer-led review clinics during the COVID-19 pandemic","authors":"Gemma Andrews, T. Flood, P. Shepherd","doi":"10.1017/S1460396921000613","DOIUrl":"https://doi.org/10.1017/S1460396921000613","url":null,"abstract":"Abstract Background and purpose: The COVID-19 pandemic has led to the introduction of alternative on-treatment and post-treatment radiographer-led review clinics in an attempt to protect patients, staff and the public. Pre-COVID, patient reviews were routinely undertaken face-to-face, led by therapeutic review radiographers with advanced practice qualifications and skills in radiotherapy symptom management, triage, referral and support services. During the COVID-19 pandemic, an alternative option has been to follow-up in the form of telephone reviews to reduce face-to-face exposure whilst continuing to manage patient radiotherapy treatment-related toxicities. The aim of the narrative review is to explore the subject of telephone reviews and how therapeutic review radiographers might need to adapt communication skills so that they can continue to effectively assess and manage radiotherapy patient treatment reactions remotely. Method and discussion: A narrative review was conducted using the SCOPUS database and 28 publications were included from 2013 to 2021. The review highlights a paucity of literature exploring specific telephone training for radiographers and other allied healthcare professionals. Experiences within medical and nursing programmes demonstrate that development and integration of training in this area is critical in preparing for patient interaction via telephone. Conclusion and implications for practice: Multiple teaching modalities including simulation are ideal for teaching telephone-specific skills and content, demonstrating improvement in student knowledge, competence and confidence. Less is known regarding whether this knowledge translates to an improved patient experience. Enhancements in education and training, guided by the Health and Care Professions Council, may be warranted to ensure that patients continue to receive the optimal quality of care in a world where remote reviews are likely to become commonplace. Patient-reported outcome measures might be utilized for future training evaluations to ensure that effective patient care is being maintained.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43783336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accelerated hypofractionated radiotherapy for chest wall and nodal irradiation using hybrid techniques","authors":"K. Balaji, V. Ramasubramanian","doi":"10.1017/S1460396921000601","DOIUrl":"https://doi.org/10.1017/S1460396921000601","url":null,"abstract":"Abstract Aim: This study compares three different hybrid plans, for left-sided chest wall (CW) and nodal stations irradiation using a hypofractionated dose regimen. Materials and methods: Planning target volumes (PTVs) of 25 breast cancer patients that included CW, supraclavicular (SCL) and internal mammary node (IMN) were planned with 3 different hybrid techniques: 3DCRT+IMRT, 3DCRT+VMAT and IMRT+VMAT. All hybrid plans were generated with a hypofractionated dose prescription of 40·5 Gy in 15 fractions. Seventy per cent of the dose was planned with the base-dose component and remaining 30% of the dose was planned with the hybrid component. All plans were evaluated based on the PTVs and organs at risk (OARs) dosimetric parameters. Results: The results for PTVs parameters have shown that the 3DCRT+IMRT and 3DCRT+VMAT plans were superior in uniformity index to the IMRT+VMAT plan. The OARs dose parameters were comparable between hybrid plans. The IMRT+VMAT plan provided a larger low dose volume spread to the heart and ipsilateral lung (p < 0·001). The 3DCRT+VMAT plan required less monitor units and treatment time (p = 0·005) than other plans. Conclusion: The 3DCRT+VMAT hybrid plan showed superior results with efficient treatment delivery and provide clinical benefit by reducing both low and high dose levels.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42632361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Slevin, R. Rieu, M. Beasley, R. Speight, K. Aitken, J. Good, F. McDonald, T. Rackley, G. Radhakrishna, A. Haridass, L. Murray, A. Tree, A. Henry
{"title":"Evaluation of the impact of teaching on delineation variation during a virtual stereotactic ablative radiotherapy contouring workshop","authors":"F. Slevin, R. Rieu, M. Beasley, R. Speight, K. Aitken, J. Good, F. McDonald, T. Rackley, G. Radhakrishna, A. Haridass, L. Murray, A. Tree, A. Henry","doi":"10.1017/S1460396921000583","DOIUrl":"https://doi.org/10.1017/S1460396921000583","url":null,"abstract":"Abstract Introduction: Variation in delineation of target volumes/organs at risk (OARs) is well recognised in radiotherapy and may be reduced by several methods including teaching. We evaluated the impact of teaching on contouring variation for thoracic/pelvic stereotactic ablative radiotherapy (SABR) during a virtual contouring workshop. Materials and methods: Target volume/OAR contours produced by workshop participants for three cases were evaluated against reference contours using DICE similarity coefficient (DSC) and line domain error (LDE) metrics. Pre- and post-workshop DSC results were compared using Wilcoxon signed ranks test to determine the impact of teaching during the workshop. Results: Of 50 workshop participants, paired pre- and post-workshop contours were available for 21 (42%), 20 (40%) and 22 (44%) participants for primary lung cancer, pelvic bone metastasis and pelvic node metastasis cases, respectively. Statistically significant improvements post-workshop in median DSC and LDE results were observed for 6 (50%) and 7 (58%) of 12 structures, respectively, although the magnitude of DSC/LDE improvement was modest in most cases. An increase in median DSC post-workshop ≥0·05 was only observed for GTVbone, IGTVlung and SacralPlex, and reduction in median LDE > 1 mm was only observed for GTVbone, CTVbone and SacralPlex. Post-workshop, median DSC values were >0·7 for 75% of structures. For 92% of the structures, post-workshop contours were considered to be acceptable or within acceptable variation following review by the workshop faculty. Conclusions: This study has demonstrated that virtual SABR contouring training is feasible and was associated with some improvements in contouring variation for multiple target volumes/OARs.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42153767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. John, A. Sathyamurthy, Shanthi Prasoona, J. Ramireddy, G. Rebekah, Saikat Das, Ph.D., Reena Mary George, S. John, T. Ram
{"title":"Patterns of care and clinical outcomes in stage IVA cervical cancer: 14-year experience from a tertiary care centre in South India","authors":"N. John, A. Sathyamurthy, Shanthi Prasoona, J. Ramireddy, G. Rebekah, Saikat Das, Ph.D., Reena Mary George, S. John, T. Ram","doi":"10.1017/S1460396921000443","DOIUrl":"https://doi.org/10.1017/S1460396921000443","url":null,"abstract":"Abstract Aim: To analyse the patterns of care and clinical outcomes of patients diagnosed with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IVA treated at a tertiary care centre in South India. Materials and methods: The electronic medical records of 2,476 patients diagnosed with cervical cancer at a tertiary care institution between January 2005 and December 2018 were reviewed. Among them, 96 patients diagnosed with histologically proven carcinoma cervix stage IVA established by either cystoscopy or proctoscopy were included. Four patients who did not receive treatment at the study centre were excluded and 92 patients were available for final analysis. Results: The median follow-up period was 12 months (2–131 months). Of the 92 patients, 59 patients (64·13%) received radiation therapy (RT) alone, 22 patients (23·9%) received chemoradiation (CRT), three patients (3·26%) received neoadjuvant chemotherapy (NACT) followed by RT, one (1·08%) received NACT followed by CRT, four patients (4·35%) received chemotherapy alone, while three (3·26%) were offered best supportive care. The median progression-free survival (PFS) was 12 months (95% CI: 9·6–14·4 months) and median overall survival (OS) was 25 months (95% CI: 16·6–33·4 months). The 2-year and 3-year PFS was 30 and 20%, respectively, and the OS was 50 and 32%, respectively. Conclusion: The management of stage IVA cervical cancer needs to be individualised to achieve a fine balance between local control, toxicity, and quality of life. RT is the mainstay of treatment with concurrent chemotherapy in carefully selected patients. Involvement of palliative care team early in the course of treatment adds a holistic approach to the continuum of oncological care.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46286897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oleg N Vassiliev, Christine B Peterson, Joe Y Chang, Radhe Mohan
{"title":"Using FFF Beams to Improve the Therapeutic Ratio of Lung SBRT.","authors":"Oleg N Vassiliev, Christine B Peterson, Joe Y Chang, Radhe Mohan","doi":"10.1017/s1460396920000576","DOIUrl":"https://doi.org/10.1017/s1460396920000576","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the extent to which lung stereotactic body radiotherapy (SBRT) treatment plans can be improved by replacing conventional flattening filter (FF) beams with flattening filter-free (FFF) beams.</p><p><strong>Material and methods: </strong>We selected 15 patients who had received SBRT with conventional 6-MV photon beams for early-stage lung cancer. We imported the patients' treatment plans into the Eclipse 13.6 treatment planning system, in which we configured the AAA dose calculation model using representative beam data for a TrueBeam accelerator operated in 6-MV FFF mode. We then created new treatment plans by replacing the conventional FF beams in the original plans with FFF beams.</p><p><strong>Results: </strong>The FFF plans had better target coverage than the original FF plans did. For the planning target volume, FFF plans significantly improved the D<sub>98</sub>, D<sub>95</sub>, D<sub>90</sub>, homogeneity index, and uncomplicated tumor control probability. In most cases, the doses to organs at risk were lower in FFF plans. FFF plans significantly reduced the mean lung dose, V<sub>10</sub>, V<sub>20</sub>, V<sub>30</sub>, and normal tissue complication probability for the total lung and improved the dosimetric indices for the ipsilateral lung. For most patients, FFF beams achieved lower maximum doses to the esophagus, heart, and the spinal cord; and a lower chest wall V<sub>30</sub>.</p><p><strong>Findings: </strong>Compared with FF beams, FFF beams achieved lower doses to organs at risk, especially the lung, without compromising tumor coverage; in fact, FFF beams improved coverage in most cases. Thus, replacing FF beams with FFF beams can achieve a better therapeutic ratio.</p>","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":"20 4","pages":"419-425"},"PeriodicalIF":0.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/s1460396920000576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40325117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Yabsantia, S. Suriyapee, N. Phaisangittisakul, S. Oonsiri, T. Sanghangthum, J. Seuntjens
{"title":"Investigation of field output factors using IAEA-AAPM TRS-483 code of practice recommendations and Monte Carlo simulation for 6 MV photon beams","authors":"S. Yabsantia, S. Suriyapee, N. Phaisangittisakul, S. Oonsiri, T. Sanghangthum, J. Seuntjens","doi":"10.1017/S1460396921000662","DOIUrl":"https://doi.org/10.1017/S1460396921000662","url":null,"abstract":"Abstract Introduction: This study aims to experimentally determine field output factors using the methodologies suggested by the IAEA-AAPM TRS-483 for small field dosimetry and compare with the calculation from Monte Carlo (MC) simulation. Methods: The IBA-CC01, Sun Nuclear EDGE and IBA-SFD detectors were employed to determine the uncorrected and the corrected field output factors for 6 MV photon beams. Measurements were performed at 100 cm source to axis distance, 10 cm depth in water, and the field sizes ranged from 1 × 1 to 10 × 10 cm2. The use of field output correction factors proposed by the TRS-483 was utilised to determine field output factors. The measured field output factors were compared to that calculated using the egs_chamber user code. Results: The decrease in the percentage standard deviation of the measured three detectors was observed after applying the field output correction factors. Measured field output factors using CC01 and EDGE detectors agreed with MC values within 3% for field sizes down to 1 × 1 cm2, except the SFD detector. Conclusions: The corrected field output factors agree with the calculation from MC, except the SFD detector. CC01 and EDGE are suitable for determining field output factors, while the SFD may need more implementation of the intermediate field method.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42290429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mona Kamal, M. Baudo, Shon Shmushkevich, Yimin Geng, M. Rahouma
{"title":"Early mortality following COVID-19 infection among cancer patients who received radiotherapy: a meta-analysis","authors":"Mona Kamal, M. Baudo, Shon Shmushkevich, Yimin Geng, M. Rahouma","doi":"10.1017/S1460396921000637","DOIUrl":"https://doi.org/10.1017/S1460396921000637","url":null,"abstract":"Abstract Introduction: Identifying the patients at higher risk for poor outcomes after radiotherapy (RT) during coronavirus disease 19 (COVID-19) era is an unmet clinical need. Methods: The Ovid MEDLINE, Ovid Embase, Clarivate Analytics Web of Science, PubMed and Wiley-Blackwell Cochrane Library databases were searched. Eligible studies were required to address the outcomes of cancer patients who underwent RT during the COVID-19 era. The primary outcome was early mortality, while secondary outcomes included length of hospital stay, hospital admission, intensive care unit (ICU) admission and use of mechanical ventilation. Pooled event rates were calculated, and meta-regression and ‘leave-one-out’ sensitivity analyses were performed. Results: Twelve eligible studies were included out of 928. The prevalence of early mortality after COVID-19 infection was 21·0%. The prevalence of hospital admission, ICU admission and mechanical ventilation was 78·1, 15·4 and 20·0%, respectively. Meta-regression showed that older age was significantly and positively associated with early mortality (β = 0·0765 ± 0·0349, p = 0·0284), while breast cancer was negatively associated with early mortality (β = −1·2754 ± 0·6373, p = 0·0454). Conclusions: Older age adversely impacts the early mortality rate in cancer patients during COVID-19 era. The risks of interruption/delay of cancer treatment should be weighed against the risk of increased morbidity and mortality from the infection. A global registry is needed to establish international oncologic guidelines during the COVID-19 era.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":"1 1","pages":"1 - 9"},"PeriodicalIF":0.4,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45661371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chaiyaporn Pintakham, E. Tharavichitkul, S. Wanwilairat, W. Nobnop
{"title":"Comparative dosimetry of brachytherapy treatment planning between a volume-based plan by CT and a point-based plan by TAUS in CT datasets for brachytherapy","authors":"Chaiyaporn Pintakham, E. Tharavichitkul, S. Wanwilairat, W. Nobnop","doi":"10.1017/S1460396921000595","DOIUrl":"https://doi.org/10.1017/S1460396921000595","url":null,"abstract":"Abstract Aim: To evaluate comparative dosimetry of brachytherapy treatment planning between a volume-based plan by computed tomography (CT) and a point-based plan by transabdominal ultrasound (TAUS) in CT datasets for brachytherapy. Materials and methods: From 2019 to 2021, 59 different datasets of CT images were collected from 38 patients treated by intracavitary brachytherapy with tandem ovoid or tandem ring applicators. At that time, TAUS was performed to prevent uterine perforation and to evaluate topography of the cervix during application. In volume-based planning by CT, the target dose was used to keep the dose at 90% of high-risk clinical target volume (HR-CTV), to give a dose of at least 7Gy, while in the point-based plan by TAUS, the target dose was used to keep the minimum dose to eight cervix reference points (measured by TAUS), to give a dose of at least 7Gy. The doses to targets and organs at risk were evaluated and compared between volume-based planning by CT and the point-based plan by TAUS. Results: Of 59 fractions, a tandem ovoid applicator was used in 48 fractions (81·3%). In the volume-based plan by CT, the mean doses to HR-CTV(D90), intermediate-risk clinical target volume (IR-CTV)(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 7·0, 3·9, 4·9, 2·9 and 3·3 Gy, respectively, while in the point-based plan by TAUS, the mean doses to HR-CTV(D90), IR-CTV(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 8·2, 4·6, 5·9, 3·4 and 3·9 Gy, respectively. The percentages of mean dose differences between TAUS and CT of HR-CTV(D90), IR-CTV(D90), bladder(D2cc), rectum(D2cc) and sigmoid colon(D2cc) were 17·7, 19·5, 20·5, 19·5, 21·3 and 19·8%, respectively. With the target dose to the point-based plan by TAUS (7 Gy to the cervix reference points), this was close to D98 of HR-CTV with a mean percentage of difference of 0·6%. Findings: The point-based plan by TAUS showed higher values to targets and organs at risk than the volume-based plan by CT. With the point-based plan by TAUS, it was close to D98 of HR-CTV.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45768593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ma, B. Yu, Lucas M. Serra, A. Bartl, O. Oladeru, M. Farrugia, Rohil Shekher, A. Iovoli, F. Fekrmandi, Han Yu, Ashutosh Kumar Singh
{"title":"Comparison of preoperative chemoradiation with radiation or chemotherapy alone in patients with non-metastatic, resectable retroperitoneal sarcoma","authors":"S. Ma, B. Yu, Lucas M. Serra, A. Bartl, O. Oladeru, M. Farrugia, Rohil Shekher, A. Iovoli, F. Fekrmandi, Han Yu, Ashutosh Kumar Singh","doi":"10.1017/S1460396921000480","DOIUrl":"https://doi.org/10.1017/S1460396921000480","url":null,"abstract":"Abstract Aim: Optimal preoperative therapy regimen in the treatment of resectable retroperitoneal sarcoma (RPS) remains unclear. This study compares the impact of preoperative radiation, chemoradiation and chemotherapy on overall survival (OS) in RPS patients. Materials and Methods: The National Cancer Database (NCDB) was queried for patients with non-metastatic, resectable RPS (2006–15). The primary endpoint was OS, evaluated by Kaplan–Meier method, log-rank test, Cox multivariable analysis and propensity score matching. Results: A total of 1,253 patients met the inclusion criteria, with 210 patients (17%) receiving chemoradiation, 850 patients (68%) receiving radiation and 193 patients (15%) receiving chemotherapy. On Cox multivariable analysis, when compared to preoperative chemoradiation, preoperative radiation was not associated with improved OS (hazards ratio [HR] 0·98, 95% CI 0·76–1·25, p = 0·84), while preoperative chemotherapy was associated with worse OS (HR 1·64, 95% CI 1·24–2·18, p < 0·001). Similar findings were observed in 199 and 128 matched pairs for preoperative radiation and chemotherapy, respectively, when compared to preoperative chemoradiation. Findings: Our study suggested an OS benefit in using preoperative chemoradiation compared to chemotherapy alone, but OS outcomes were comparable between preoperative chemoradiation and radiation alone.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45204497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}