Five-Day Preoperative Radiation Therapy for Patients With High-Risk Soft Tissue Sarcoma

作者：John Nikitas, Joseph K. Kendal, Ricky R. Savjani, Nicholas Jackson, Nicholas Peterson, Jie Deng, Jackie Hernandez, Natalie Chong, Arun S. Singh, Bartosz Chmielowski, Noah Federman, Joseph G. Crompton, Brian E. Kadera, Lauren E. Wessel, Alexander B. Christ, Scott D. Nelson, Sarah Dry, Joanne B. Weidhaas, Michael L. Steinberg, Nicholas M. Bernthal, Fritz C. Eilber, Anusha Kalbasi, Vishruth K. Reddy · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.50195 · 被引用次数：5 · 研究领域：Sarcoma Diagnosis and Treatment、Colorectal and Anal Carcinomas、Gastrointestinal Tumor Research and Treatment

Importance: Standard preoperative radiotherapy (RT) for high-risk soft tissue sarcoma (STS) is delivered over 5 weeks, which can be a logistical challenge for patients. Objective: To evaluate the long-term toxic effects and clinical outcomes associated with a shorter 5-day, dose-equivalent preoperative RT regimen. Design, Setting, and Participants: Phase 2, single-group nonrandomized trial with an initial cohort (April 2016 to May 2018) and expansion cohort (October 2018 to May 2023) at a single academic center in the US. Participants were patients with histologically confirmed extremity or trunk STS recommended to undergo standard preoperative RT and surgery. Patients with planned neoadjuvant systemic therapy who were enrolled in the expansion group were excluded from this analysis. Analysis was conducted September 2024 to August 2025. Intervention: A total of 30 Gy in 5 fractions were delivered preoperatively. Main Outcomes and Measures: The primary end point was 2-year grade 2 or higher radiation toxic effects. Secondary end points included major wound complications (MWC), local failure, distant progression, and overall survival. Results: A total of 110 patients were treated with preoperative RT and surgery (42 patients [38%] were aged 65-79 years; 64 [58%] were male; 75 had tumors of the lower extremity [68%], and 64 patients [58%] had high-grade disease). The initial cohort accrued 50 patients who underwent surgery. The expansion cohort accrued 83 patients; 60 of 83 were...