News | February 11, 2015

Image-Guided Pre-Surgery Radiation Significantly Reduces Long-Term Negative Impact in Certain Cancers

New standard of care targeted toward soft tissue cancers in the extremities

February 11, 2015 — Using advanced imaging technology to more precisely target radiation beams to treat soft tissue cancers (sarcomas) in the extremities significantly reduces long term side effects without effecting survival rates, according to research results published online in the Journal of Clinical Oncology.

The findings should establish a new standard of care for soft tissue sarcomas. “This study proves that we are able to use this modern technology  — image-guided radiotherapy — to irradiate smaller target volumes  and reduce long-term side effects in extremity sarcoma patients compared with conventional radiotherapy,” says Dian Wang, M.D., the lead author of the paper. He is professor of radiation oncology at Rush University Medical Center and chair of the NRG Oncology Sarcoma Working Group.

“This is one of few successful multi-institutional studies on localized sarcoma in almost a decade,” Wang said “It should provide oncologists with validation and evidence of this new radiotherapy approach that takes full advantage of rapidly developing technologies. The absence of marginal-field recurrence and favorable toxicity profiles suggest that parameters used in this study are appropriate for preoperative image-guided radiotherapy of extremity sarcoma,” Wang added.

The study results came from a multi-year, multi-institution phase 2 clinical trial conducted by the Radiation Therapy Oncology Group (RTOG), now conducting research as NRG Oncology.

The RTOG 0630 trial studied more than 100 patients with extremity-based soft tissue sarcomas (STS) who received pre-surgical radiation delivered to a substantially smaller area than typically targeted when treating this type of cancer. Prior to tumor removal surgery, a series of daily pre-treatment images of the tumor were digitally integrated with previous scans to determine a custom-tailored radiation dose that minimized exposure to adjacent normal tissue. Assessments two years later showed that long-term side effects were 10.5 percent, significantly fewer than the 37 percent of patients in a previous study who received radiation to a larger target area.

The trial was conducted over three years at 18 medical centers across the country.

For more information: www.nrgoncology.org

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