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. 2021 Mar 16;13(6):1332.
doi: 10.3390/cancers13061332.

The Feasibility Study of Hypofractionated Radiotherapy with Regional Hyperthermia in Soft Tissue Sarcomas

Mateusz Jacek Spałek  1 , Aneta Maria Borkowska  1 , Maria Telejko  2 , Michał Wągrodzki  3 , Daria Niebyłowska  2 , Aldona Uzar  2 , Magdalena Białobrzeska  2 , Piotr Rutkowski  1
Affiliations

The Feasibility Study of Hypofractionated Radiotherapy with Regional Hyperthermia in Soft Tissue Sarcomas

Mateusz Jacek Spałek et al. Cancers (Basel). .

Abstract

Introduction: Management of marginally resectable or unresectable soft tissue sarcomas (STS) in patients who are not candidates for neoadjuvant chemotherapy due to chemoresistant pathology or contraindications remains a challenge. Therefore, in these indications, we aimed to investigate a feasibility of 10x 3.25 Gy radiotherapy combined with regional hyperthermia (HT) that could be followed by surgery or 4x 4 Gy radiotherapy with HT.

Materials and methods: We recruited patients with locally advanced marginally resectable or unresectable STS who (1) presented chemoresistant STS subtype, or (2) progressed after neoadjuvant chemotherapy, or (3) were unfit for chemotherapy. The primary endpoint was the feasibility of the proposed regimen.

Results: Thirty patients were enrolled. All patients received the first part of the treatment, namely radiotherapy with HT. Among them, 14 received the second part of radiotherapy with HT whereas 13 patients underwent surgery. Three patients did not complete the treatment protocol. The feasibility criteria were fulfilled in 90% of patients. Two patients developed distant metastases. One patient died due to distant progression. One patient developed rapid local recurrence after surgery.

Conclusions: Hypofractionated radiotherapy with HT is a feasible treatment for marginally resectable or unresectable STS in patients who are not candidates for chemotherapy. Results of this clinical trial support the further validation of RT and HT combinations in STS.

Keywords: hyperthermia; hypofractionated radiotherapy; neoadjuvant therapy; radiotherapy; sarcoma; thermotherapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Treatment schedule.
Figure 2
Figure 2
Histological response to the treatment: (A) A pleomorphic rhabdomyosarcoma before treatment confirmed by the myogenin expression (clone F5D, Daco, inlet); (B) diffuse necrotic changes in the pleomorphic rhabdomyosarcoma after treatment with only single, degenerated neoplastic cells present (less than 1% of tumoral tissue, inlet); (C) biopsy of a high-grade, undifferentiated spindle cell and focally pleomorphic sarcoma with brisk mitotic activity (inlet); (D) diffuse sclerosis with focal calcifications and scattered lymphocytic infiltrates in more fibrotic areas (inlet) in the undifferentiated sarcoma after treatment.
See this image and copyright information in PMC

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