Local control and postponement of systemic therapy after modest dose radiotherapy in oligometastatic myxoid liposarcomas

Jules Lansu, Winan J. van Houdt, Kirsten van Langevelde, Piet L. A. van den Ende, Winette T. A. van der Graaf, Yvonne Schrage, Hester van Boven, Astrid N. Scholten, Rick L. Haas*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Oligometastatic disease and/or oligoprogression in myxoid liposarcoma(oMLS) triggers discussions on local treatment options and delay of systemic treatments. We hypothesized that satisfactory local control and postponement of systemic therapy could be achieved with a modest radiotherapy(RT) dose in oMLS.

Methods: The DOREMY trial is a multicenter, phase 2 trial evaluating efficacy and toxicity of a modest RT dose in both localized and oMLS; this report presents the data of the oMLS cohort treated with 36 Gy in 12-18 fractions with optional subsequent metastasectomy. The primary endpoint was local progression free survival(LPFS). Secondary endpoints included postponement of systemic therapy, symptom reduction, radiological objective response, and toxicity.

Results: Nine patients with a total of 25 lesions were included, with a median follow-up of 23 months. The median number of lesions per patient was three and the trunk wall and bone were the most frequently affected sites. In lesions treated with definitive RT(n = 21), LPFS rates at 1, 2, and 3 years were respectively 73%, 61%, and 40%. Radiological objective response and clinical symptom reduction were achieved in 8/15(53%) and 9/10(90%) of the evaluable lesions, respectively. No local recurrences occurred in lesions treated with RT and metastasectomy(n = 4). For the entire study population, the median postponement of systemic therapy was 10 months. Grade >= 2 toxicity was observed in 2/9(22%) of patients.

Conclusions: This trial suggests that 36 Gy could possibly be effective to achieve local control, postpone systemic therapy and reduce symptoms in oMLS. Given the minimal toxicity this treatment could be reasonably considered in oMLS.

(c) 2021 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 158 (2021) 33-39

Original languageEnglish
Pages (from-to)33-39
Number of pages7
JournalRadiotherapy and Oncology
Volume158
DOIs
Publication statusPublished - May 2021

Keywords

  • Myxoid liposarcoma
  • Myxoid liposarcomas
  • Soft tissue sarcoma
  • soft tissue sarcomas
  • Metastatic
  • Palliative therapy
  • Adjuvant radiotherapy
  • SOFT-TISSUE SARCOMA
  • TUMOR RESPONSE ASSESSMENT
  • RADIATION-THERAPY
  • PREOPERATIVE RADIOTHERAPY
  • PATHOLOGICAL RESPONSE
  • CHOI CRITERIA
  • TRABECTEDIN
  • CHEMOTHERAPY
  • DOXORUBICIN
  • METASTASES

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