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Radiotherapy for soft tissue sarcoma of the proximal lower extremity.

Prendergast B, Fiveash JB, Gibbs CP, Scarborough MT, Indelicato DJ - Sarcoma (2010)

Bottom Line: Soft-tissue sarcoma (STS) is a histopathologically diverse group of tumors accounting for approximately 10,000 new malignancies in the US each year.The proximal lower extremity is the most common site for STS, accounting for approximately one-third of all cases.Coordinated multimodality management in the form of surgery and radiation is often critical to local control, limb preservation, and functional outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL 35294-1150, USA.

ABSTRACT
Soft-tissue sarcoma (STS) is a histopathologically diverse group of tumors accounting for approximately 10,000 new malignancies in the US each year. The proximal lower extremity is the most common site for STS, accounting for approximately one-third of all cases. Coordinated multimodality management in the form of surgery and radiation is often critical to local control, limb preservation, and functional outcome. Based on a review of currently available Medline literature and professional experience, this paper provides an overview of the treatment of STS of the lower extremity with a particular focus on the modern role of radiotherapy.

No MeSH data available.


Related in: MedlinePlus

Comparison of preoperative proton (a) and photon (b) dosimetry for soft tissue sarcoma of the thigh shown in Figure 1. The tumor target volume is outlined in yellow and the anus is outlined in aqua blue. Note how the proton plan spares the perineal region and lymphatic drainage of uninvolved soft tissue.
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Related In: Results  -  Collection


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fig2: Comparison of preoperative proton (a) and photon (b) dosimetry for soft tissue sarcoma of the thigh shown in Figure 1. The tumor target volume is outlined in yellow and the anus is outlined in aqua blue. Note how the proton plan spares the perineal region and lymphatic drainage of uninvolved soft tissue.

Mentions: Like IMRT, proton therapy is recognized by US cooperative groups as a viable option to improve the therapeutic ratio of radiation for STS in adults [68] and children [69]. Favorable outcomes with proton therapy have been published for sarcomas of the head and neck, skull base, and spinal cord [70]. Due to the cost and limited access to facilities, proton therapy has not been routinely used in the management of STS of the proximal lower extremity, but in select cases it may be advantageous as it offers the conformality of IMRT with the minimal integral tissue dose of 3D-CRT (Figure 2). The radiobiologic characteristics of protons are more similar to photons than neutrons and, therefore, there is a diminished concern regarding late effects.


Radiotherapy for soft tissue sarcoma of the proximal lower extremity.

Prendergast B, Fiveash JB, Gibbs CP, Scarborough MT, Indelicato DJ - Sarcoma (2010)

Comparison of preoperative proton (a) and photon (b) dosimetry for soft tissue sarcoma of the thigh shown in Figure 1. The tumor target volume is outlined in yellow and the anus is outlined in aqua blue. Note how the proton plan spares the perineal region and lymphatic drainage of uninvolved soft tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2957855&req=5

fig2: Comparison of preoperative proton (a) and photon (b) dosimetry for soft tissue sarcoma of the thigh shown in Figure 1. The tumor target volume is outlined in yellow and the anus is outlined in aqua blue. Note how the proton plan spares the perineal region and lymphatic drainage of uninvolved soft tissue.
Mentions: Like IMRT, proton therapy is recognized by US cooperative groups as a viable option to improve the therapeutic ratio of radiation for STS in adults [68] and children [69]. Favorable outcomes with proton therapy have been published for sarcomas of the head and neck, skull base, and spinal cord [70]. Due to the cost and limited access to facilities, proton therapy has not been routinely used in the management of STS of the proximal lower extremity, but in select cases it may be advantageous as it offers the conformality of IMRT with the minimal integral tissue dose of 3D-CRT (Figure 2). The radiobiologic characteristics of protons are more similar to photons than neutrons and, therefore, there is a diminished concern regarding late effects.

Bottom Line: Soft-tissue sarcoma (STS) is a histopathologically diverse group of tumors accounting for approximately 10,000 new malignancies in the US each year.The proximal lower extremity is the most common site for STS, accounting for approximately one-third of all cases.Coordinated multimodality management in the form of surgery and radiation is often critical to local control, limb preservation, and functional outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL 35294-1150, USA.

ABSTRACT
Soft-tissue sarcoma (STS) is a histopathologically diverse group of tumors accounting for approximately 10,000 new malignancies in the US each year. The proximal lower extremity is the most common site for STS, accounting for approximately one-third of all cases. Coordinated multimodality management in the form of surgery and radiation is often critical to local control, limb preservation, and functional outcome. Based on a review of currently available Medline literature and professional experience, this paper provides an overview of the treatment of STS of the lower extremity with a particular focus on the modern role of radiotherapy.

No MeSH data available.


Related in: MedlinePlus