Michael Allen1, Daniella Silvino2, Mitchell Kamrava3, Wonwoo Shon4, Earl Brien5. 1. Department of Orthopaedic Surgery, Community Memorial Health System, 147 N Brent St. Ventura, CA 93003, United States of America. Electronic address: mallen@cmhshealth.org. 2. NYIT College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, NY 1145, United States of America. 3. Department of Radiation Oncology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America. 4. Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America. 5. Department of Orthopaedic Surgery, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States of America.
Abstract
INTRODUCTION: Large high-grade sarcomas are commonly managed with five weeks of pre-operative radiation with chemotherapy followed by surgical resection. Wound complications occur in about one out of three patients with this regimen. Hypofractionated radiation therapy (HFRT) is a developing pre-operative approach that delivers radiation over a shorter duration of 5-10 treatments. PRESENTATION OF CASE: Two patients underwent HFRT with neoadjuvant chemotherapy followed by tumor resection. The first patient had high-grade de-differentiated liposarcoma, and the second patient a high-grade myxofibrosarcoma. Neither patient developed post-operative wound complications despite the massive tumor size. DISCUSSION: Less is understood regarding rates and risk factors associated with wound complications using this shortened radiation approach. With attention to surgical detail, and advancing radiation delivery technologies, rates of complications can be minimized. CONCLUSION: We discuss our experience with a neoadjuvant hypofractionated chemoradiation protocol in two patients with large volume sarcomas resected from the chest wall and the thigh who did not develop acute wound complications. Further evaluation of this shortened regimen is warranted.
INTRODUCTION: Large high-grade sarcomas are commonly managed with five weeks of pre-operative radiation with chemotherapy followed by surgical resection. Wound complications occur in about one out of three patients with this regimen. Hypofractionated radiation therapy (HFRT) is a developing pre-operative approach that delivers radiation over a shorter duration of 5-10 treatments. PRESENTATION OF CASE: Two patients underwent HFRT with neoadjuvant chemotherapy followed by tumor resection. The first patient had high-grade de-differentiated liposarcoma, and the second patient a high-grade myxofibrosarcoma. Neither patient developed post-operative wound complications despite the massive tumor size. DISCUSSION: Less is understood regarding rates and risk factors associated with wound complications using this shortened radiation approach. With attention to surgical detail, and advancing radiation delivery technologies, rates of complications can be minimized. CONCLUSION: We discuss our experience with a neoadjuvant hypofractionated chemoradiation protocol in two patients with large volume sarcomas resected from the chest wall and the thigh who did not develop acute wound complications. Further evaluation of this shortened regimen is warranted.
Authors: Long Liang; Taiyu Chen; Tao Ren; Mian Mao; Keli Wang; Chunhan Tang; Juan Xiao; Hongyuan Jia; Wenli Chen; Qifeng Wang; Tao Li Journal: Cancer Manag Res Date: 2022-01-06 Impact factor: 3.989