TY - JOUR
T1 - A prospective study of proton reirradiation for recurrent and secondary soft tissue sarcoma
AU - Guttmann, David M.
AU - Frick, Melissa A.
AU - Carmona, Ruben
AU - Deville, Curtiland
AU - Levin, William P.
AU - Berman, Abigail T.
AU - Chinniah, Chidambaram
AU - Hahn, Stephen M.
AU - Plastaras, John P.
AU - Simone, Charles B.
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/8
Y1 - 2017/8
N2 - Background and purpose Proton reirradiation for sarcoma has not been previously described. We hypothesized that this strategy would provide favorable toxicity and survival outcomes. Material and methods Patients with soft tissue sarcoma in a previously-irradiated field were enrolled on a prospective trial of proton reirradiation. The primary endpoint was provider-reported acute toxicity. Secondary endpoints included late toxicities, local control, and overall survival. Results 23 patients underwent proton reirradiation. Median time between radiation courses was 40.7 months (range 10–272). No grade 4–5 toxicities were observed. One patient (4%) experienced acute grade 3 dysphagia. Common grade 2 acute toxicities were fatigue (26%), anorexia (17%), and urinary incontinence (13%). There were two grade 3 late wound infections (10%) and one grade 3 late wound complication (5%). Grade 2 late complications included lymphedema (10%), fracture (5%), and fibrosis (5%). At a median follow-up of 36 months, the 3-year cumulative incidence of local failure was 41% (95% CI [20–63%]). Median overall survival and progression-free survival were 44 and 29 months, respectively. In extremity patients, amputation was spared in 7/10 (70%). Conclusions Proton reirradiation of recurrent/secondary soft tissue sarcomas is well tolerated. While longer follow-up is needed, early survival outcomes in this high-risk population are encouraging.
AB - Background and purpose Proton reirradiation for sarcoma has not been previously described. We hypothesized that this strategy would provide favorable toxicity and survival outcomes. Material and methods Patients with soft tissue sarcoma in a previously-irradiated field were enrolled on a prospective trial of proton reirradiation. The primary endpoint was provider-reported acute toxicity. Secondary endpoints included late toxicities, local control, and overall survival. Results 23 patients underwent proton reirradiation. Median time between radiation courses was 40.7 months (range 10–272). No grade 4–5 toxicities were observed. One patient (4%) experienced acute grade 3 dysphagia. Common grade 2 acute toxicities were fatigue (26%), anorexia (17%), and urinary incontinence (13%). There were two grade 3 late wound infections (10%) and one grade 3 late wound complication (5%). Grade 2 late complications included lymphedema (10%), fracture (5%), and fibrosis (5%). At a median follow-up of 36 months, the 3-year cumulative incidence of local failure was 41% (95% CI [20–63%]). Median overall survival and progression-free survival were 44 and 29 months, respectively. In extremity patients, amputation was spared in 7/10 (70%). Conclusions Proton reirradiation of recurrent/secondary soft tissue sarcomas is well tolerated. While longer follow-up is needed, early survival outcomes in this high-risk population are encouraging.
KW - Anorexia/etiology
KW - Deglutition Disorders/etiology
KW - Disease-Free Survival
KW - Fatigue/etiology
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local/diagnostic imaging
KW - Prospective Studies
KW - Proton Therapy/adverse effects
KW - Radiation Injuries/etiology
KW - Re-Irradiation/adverse effects
KW - Sarcoma/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85022009386&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000411305300014&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.radonc.2017.06.024
DO - 10.1016/j.radonc.2017.06.024
M3 - Article
C2 - 28697854
SN - 0167-8140
VL - 124
SP - 271
EP - 276
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -