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Title: Effectiveness of Radiotherapy in Myxoid Sarcomas Is Associated With a Dense Vascular Pattern

Abstract

Purpose: Surgery and adjuvant radiotherapy (RT) have long been the standard treatment for most deep-seated sarcomas; however, since the randomized trial from the National Cancer Institute of Canada, which described similar local control for pre- vs. postoperative RT, both modalities are now widely accepted. As a group, sarcomas are classified as radiation resistant. The subgroup of myxoid liposarcoma (MLS), a sarcoma with a typical vascular crow's feet pattern, is highly radiosensitive, but a mechanism for this phenomenon is unknown. Here we describe our results with preoperative RT and propose a mechanism explaining the high sensitivity based on the distinctive vascularization pattern of MLS. Methods and Materials: Between 2002 and 2006, 31 sarcoma patients, including 10 with MLS, underwent preoperative RT at our institute. Resected specimens were histologically evaluated, focusing on classification, grade, and vascularization patterns. Results: Twenty sarcomas showed more than 80% pathologic response after preoperative RT. A pathologic complete response was found in all 'pure' MLS specimens after preoperative RT (n = 8). There were no pathologic complete responses in the remaining sarcoma patients (n = 23), although 12 showed 80% to 90% pathologic response. In contrast to the remaining RT-resistant sarcomas, the highly responding specimens contained branching vasculature,more » partial thrombus formation and inflammation of medium sized arterioles, similar to the vascular changes in MLS. Conclusions: Both MLS and sarcomas with MLS-like vasculature are highly radiosensitive. Radiation sensitivity may be explained by changes in medium-sized arterioles, obstructing the specific crow's feet vascularization and inducing hypoxia with secondary tumor cell death.« less

Authors:
 [1];  [2];  [3];  [4];  [5]
  1. Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands), E-mail: r.d.vreeze@nki.nl
  2. Department of Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  3. Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  4. Department of Experimental Therapy and Radiobiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  5. Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
Publication Date:
OSTI Identifier:
21172509
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 72; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2008.03.008; PII: S0360-3016(08)00417-3; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANOXIA; BRANCHING RATIO; DEATH; INFLAMMATION; PATIENTS; RADIOTHERAPY; SARCOMAS; SENSITIVITY; SURGERY; TUMOR CELLS

Citation Formats

Vreeze, Ronald S.A. de, Jong, Daphne de, Haas, Rick L., Stewart, Fiona, and Coevorden, Frits van. Effectiveness of Radiotherapy in Myxoid Sarcomas Is Associated With a Dense Vascular Pattern. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.03.008.
Vreeze, Ronald S.A. de, Jong, Daphne de, Haas, Rick L., Stewart, Fiona, & Coevorden, Frits van. Effectiveness of Radiotherapy in Myxoid Sarcomas Is Associated With a Dense Vascular Pattern. United States. doi:10.1016/j.ijrobp.2008.03.008.
Vreeze, Ronald S.A. de, Jong, Daphne de, Haas, Rick L., Stewart, Fiona, and Coevorden, Frits van. Mon . "Effectiveness of Radiotherapy in Myxoid Sarcomas Is Associated With a Dense Vascular Pattern". United States. doi:10.1016/j.ijrobp.2008.03.008.
@article{osti_21172509,
title = {Effectiveness of Radiotherapy in Myxoid Sarcomas Is Associated With a Dense Vascular Pattern},
author = {Vreeze, Ronald S.A. de and Jong, Daphne de and Haas, Rick L. and Stewart, Fiona and Coevorden, Frits van},
abstractNote = {Purpose: Surgery and adjuvant radiotherapy (RT) have long been the standard treatment for most deep-seated sarcomas; however, since the randomized trial from the National Cancer Institute of Canada, which described similar local control for pre- vs. postoperative RT, both modalities are now widely accepted. As a group, sarcomas are classified as radiation resistant. The subgroup of myxoid liposarcoma (MLS), a sarcoma with a typical vascular crow's feet pattern, is highly radiosensitive, but a mechanism for this phenomenon is unknown. Here we describe our results with preoperative RT and propose a mechanism explaining the high sensitivity based on the distinctive vascularization pattern of MLS. Methods and Materials: Between 2002 and 2006, 31 sarcoma patients, including 10 with MLS, underwent preoperative RT at our institute. Resected specimens were histologically evaluated, focusing on classification, grade, and vascularization patterns. Results: Twenty sarcomas showed more than 80% pathologic response after preoperative RT. A pathologic complete response was found in all 'pure' MLS specimens after preoperative RT (n = 8). There were no pathologic complete responses in the remaining sarcoma patients (n = 23), although 12 showed 80% to 90% pathologic response. In contrast to the remaining RT-resistant sarcomas, the highly responding specimens contained branching vasculature, partial thrombus formation and inflammation of medium sized arterioles, similar to the vascular changes in MLS. Conclusions: Both MLS and sarcomas with MLS-like vasculature are highly radiosensitive. Radiation sensitivity may be explained by changes in medium-sized arterioles, obstructing the specific crow's feet vascularization and inducing hypoxia with secondary tumor cell death.},
doi = {10.1016/j.ijrobp.2008.03.008},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 72,
place = {United States},
year = {2008},
month = {12}
}