Dose Reduction of Preoperative Radiotherapy in Myxoid Liposarcoma

作者：Jules Lansu, Judith V.M.G. Bovée, Pètra M. Braam, Hester van Boven, Uta Flucke, Johannes J. Bonenkamp, Aisha B. Miah, S M H Zaidi, Khin Thway, ØYVIND S. BRULAND, Elizabeth Healey Baldini, Nina Louise Jebsen, Ap Scholten, Piet L.A. van den Ende, Augustinus D. G. Krol, Jan F. Ubbels, Jos A. van der Hage, Erik D. van Werkhoven, Houke M. Klomp, Winette T.A. van der Graaf, Frits van Coevorden, Yvonne M. Schrage, Winan J. van Houdt, Rick L. Haas · 发表于：JAMA Oncology · 年份：2020 · DOI：10.1001/jamaoncol.2020.5865 · 被引用次数：107 · 研究领域：Sarcoma Diagnosis and Treatment、Surgical site infection prevention、Bone Tumor Diagnosis and Treatments

IMPORTANCE: Currently, preoperative radiotherapy for all soft-tissue sarcomas is identical at a 50-Gy dose level, which can be associated with morbidity, particularly wound complications. The observed clinical radiosensitivity of the myxoid liposarcoma subtype might offer the possibility to reduce morbidity. OBJECTIVE: To assess whether a dose reduction of preoperative radiotherapy for myxoid liposarcoma would result in comparable oncological outcome with less morbidity. DESIGN, SETTING, AND PARTICIPANTS: The Dose Reduction of Preoperative Radiotherapy in Myxoid Liposarcomas (DOREMY) trial is a prospective, single-group, phase 2 nonrandomized controlled trial being conducted in 9 tertiary sarcoma centers in Europe and the US. Participants include adults with nonmetastatic, biopsy-proven and translocation-confirmed myxoid liposarcoma of the extremity or trunk who were enrolled between November 24, 2010, and August 1, 2019. Data analyses, using both per-protocol and intention-to-treat approaches, were conducted from November 24, 2010, to January 31, 2020. INTERVENTIONS: The experimental preoperative radiotherapy regimen consisted of 36 Gy in once-daily 2-Gy fractions, with subsequent definitive surgical resection after an interval of 4 or more weeks. MAIN OUTCOMES AND MEASURES: As a short-term evaluable surrogate for local control, the primary end point was centrally reviewed pathologic treatment response. The experimental regimen was regarded as a success when 70% or more of t...