Dr. Lawrenz on Hypofractionated Radiotherapy in Soft Tissue Sarcoma

Joshua M. Lawrenz, MD, a fellow in musculoskeletal oncology at Vanderbilt University Medical Center, discusses a study looking at hypofractionated radiotherapy in soft tissue sarcoma.

With soft tissue sarcoma, radiation is usually given in the neoadjuvant or adjuvant setting, explains Lawrenz. In the neoadjuvant setting, radiation is often given in a conventional matter at 50 Gy/25 fractions, which takes about 5 weeks to administer. After that period of radiation treatment, patients wait about 3 to 6 weeks before receiving surgical resection. In total, the treatment process means patients wait about 2 to 3 months before surgical resection occurs.

In a study at the Cleveland Clinic looking at hypofractionated radiotherapy, patients received 5 days of radiation therapy followed by immediate resection of the tumor, meaning the entire treatment is condensed from 2 to 3 months down to 2 to 3 weeks.

The 16 patients who have been treated at the Cleveland Clinic for the past 3 years received 5 fractions of radiotherapy on 5 consecutive days and underwent immediate surgical resection 0 to 7 days later. Lawrenz feels that the median follow-up of approximately 8 months was adequate time to account for wound complications and toxicity, but not long enough to account for local recurrence rates, concludes Lawrenz.