POSTER REVIEW ABSTRACTS' Soft tissue sarcomas

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POSTER REVIEW ABSTRACTS.Soft tissue sarcomas

• Ignacio Azinovic
• USP Hospital San Jaime
• Torrevieja. Alicante. Spain

5th ISIORT. Madrid 2008
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8 poster abstracts

• Institutional experiences (7/8)
• 4 papers HGUGM. 73 patients
• Institutional experience.
• Miscelaneous
• Extremities
• Retroperitoneal
• 1 paper Mayo Arizona. 80 patients (48 w IOERT)
• 1 paper Ramon Cajal , Madrid. 29 patients
• 1 paper. Aggresive fibromatosis. 28 patients
• Investigational report

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Results. Madrid experience

• IOERT as boost given during surgery
• Local failure rates are low
• Extremities/trunk 10-20
• Retroperitoneal 41
• Hospital Ramon y Cajal. Short f/u.
• The problem of surgical margins
• Histology
• Good functional outcome. 83 limb sparing.
• Systemic disease

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Mayo- Arizona

• Preoperative radiotherapy
• 48 patients. Diameter (median) 8, 5 cm
• Extremities and trunk
• Neoadjuvant Chemo 16 p
• Concurrent 20p
• Local relapses 4 (8)
• 16 p (33) wound complications
• No clear factors for local control
• Systemic disease (high grade STS) as a problem in
  management.

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Aggresive fibromatosis (n 28)Heidelberg

• IOERT 12 Gy
• EBRT 45 Gy (36-54)
• Margins close 6 micro11 macro 11.
• 5 local recurrences (19)
• Residual disease, presentation (primary or
  recurrent), size or location showed no impact on
  local control.

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Biological modelling. Ramon y Cajal. Madrid

• IOERT, HDR, EBRT
• LQ model.
• Improve the thepapeutic ratio
• Best strategy
• IOERT (9 Gy) HDRBT (10 x 3,4 Gy, 5 d)
• Worst strategy IOERT EBRT

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Personal thoughts for expanding IOERT in STS

• The patterns of failure are well established
• Toxicity profile is acceptable, no neuropathies.
• Prognostic factors from pooled analysis and
  institutional experiences should help us to move
  forward.
• Improve therapeutic ratio. Dose escalation
• IMRT to the margin
• HDR
• Chemotherapy (Concurrent)