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Title: Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many ofmore » the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy and toxicity.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ;  [8] ;  [9] ;  [10] ;  [4] ;  [11] ;  [12] ;  [2] ;  [13]
  1. Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts (United States)
  2. Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)
  3. Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  4. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)
  5. Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States)
  6. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)
  7. Department of Radiation Oncology, Centre Hospitalier de l'Université de Montreal, Montreal, Quebec (Canada)
  8. Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States)
  9. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States)
  10. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States)
  11. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)
  12. Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France)
  13. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)
Publication Date:
OSTI Identifier:
22462354
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 92; Journal Issue: 3; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; EXTERNAL BEAM RADIATION THERAPY; EXTRAPOLATION; LIMITING VALUES; MEDICAL PERSONNEL; ORGANS; PANELS; PATIENTS; RADIATION DOSES; RECOMMENDATIONS; REVIEWS; SARCOMAS; SURGERY; TOXICITY