External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis

Markus Albertsmeier, Alexandra Rauch, Falk Roeder, Sandro Hasenhütl, Sebastian Pratschke, Michaela Kirschneck, Alessandro Gronchi, Nina L Jebsen, Philippe A Cassier, Paul Sargos, Claus Belka, Lars H Lindner, Jens Werner, Martin K Angele

Research output: Contribution to journalArticle

Abstract

PURPOSE: The aim of this study was to evaluate the role of preoperative and postoperative external beam radiation therapy (EBRT) in the treatment of resectable soft tissue sarcomas (STSs) of different tumor locations.

METHODS: A systematic literature search was performed to identify studies investigating the effects of EBRT (versus no EBRT) on local recurrence (LR) and overall survival (OS) or comparing different EBRT sequences. Random effects meta-analyses were calculated and presented as cumulative odds ratios (ORs).

RESULTS: Sixteen studies (n = 3958 patients) comparing EBRT versus no EBRT, including one randomized controlled trial (RCT) in extremity sarcoma, were analyzed. EBRT appeared to reduce LR in both retroperitoneal tumors (OR 0.47, p < 0.0001) and other locations (OR 0.49, p = 0.001). OS was improved by EBRT in retroperitoneal STSs (OR 0.37, p < 0.0001) but not in other tumor locations. Eleven studies (n = 2140), including one RCT, compared preoperative and postoperative radiotherapy. LR was less frequent following preoperative EBRT in retroperitoneal STSs (OR 0.03, p = 0.02), as well as in other tumor locations (OR 0.67, p = 0.01), while wound complications in extremity sarcoma were more frequent following preoperative EBRT (OR 2.92, p < 0.0001). Several studies included in this meta-analysis bear a high risk of bias and no RCT has been published for retroperitoneal STS.

CONCLUSIONS: This meta-analysis supports the use of EBRT for local tumor control in patients with resectable STSs. Based on a small number of non-randomized studies, a positive effect on OS may exist in the subgroup of retroperitoneal STSs.

Original languageEnglish
Pages (from-to)754-767
Number of pages14
JournalAnnals of Surgical Oncology
Volume25
Issue number3
DOIs
Publication statusPublished - Mar 2018

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Sarcoma
Meta-Analysis
Radiotherapy
Odds Ratio
Randomized Controlled Trials
Neoplasms
Recurrence
Survival
Extremities

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Albertsmeier, M., Rauch, A., Roeder, F., Hasenhütl, S., Pratschke, S., Kirschneck, M., ... Angele, M. K. (2018). External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis. Annals of Surgical Oncology, 25(3), 754-767. https://doi.org/10.1245/s10434-017-6081-2

External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma : A Systematic Review and Meta-Analysis. / Albertsmeier, Markus; Rauch, Alexandra; Roeder, Falk; Hasenhütl, Sandro; Pratschke, Sebastian; Kirschneck, Michaela; Gronchi, Alessandro; Jebsen, Nina L; Cassier, Philippe A; Sargos, Paul; Belka, Claus; Lindner, Lars H; Werner, Jens; Angele, Martin K.

In: Annals of Surgical Oncology, Vol. 25, No. 3, 03.2018, p. 754-767.

Research output: Contribution to journalArticle

Albertsmeier, M, Rauch, A, Roeder, F, Hasenhütl, S, Pratschke, S, Kirschneck, M, Gronchi, A, Jebsen, NL, Cassier, PA, Sargos, P, Belka, C, Lindner, LH, Werner, J & Angele, MK 2018, 'External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis', Annals of Surgical Oncology, vol. 25, no. 3, pp. 754-767. https://doi.org/10.1245/s10434-017-6081-2
Albertsmeier, Markus ; Rauch, Alexandra ; Roeder, Falk ; Hasenhütl, Sandro ; Pratschke, Sebastian ; Kirschneck, Michaela ; Gronchi, Alessandro ; Jebsen, Nina L ; Cassier, Philippe A ; Sargos, Paul ; Belka, Claus ; Lindner, Lars H ; Werner, Jens ; Angele, Martin K. / External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma : A Systematic Review and Meta-Analysis. In: Annals of Surgical Oncology. 2018 ; Vol. 25, No. 3. pp. 754-767.
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T1 - External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma

T2 - A Systematic Review and Meta-Analysis

AU - Albertsmeier, Markus

AU - Rauch, Alexandra

AU - Roeder, Falk

AU - Hasenhütl, Sandro

AU - Pratschke, Sebastian

AU - Kirschneck, Michaela

AU - Gronchi, Alessandro

AU - Jebsen, Nina L

AU - Cassier, Philippe A

AU - Sargos, Paul

AU - Belka, Claus

AU - Lindner, Lars H

AU - Werner, Jens

AU - Angele, Martin K

PY - 2018/3

Y1 - 2018/3

N2 - PURPOSE: The aim of this study was to evaluate the role of preoperative and postoperative external beam radiation therapy (EBRT) in the treatment of resectable soft tissue sarcomas (STSs) of different tumor locations.METHODS: A systematic literature search was performed to identify studies investigating the effects of EBRT (versus no EBRT) on local recurrence (LR) and overall survival (OS) or comparing different EBRT sequences. Random effects meta-analyses were calculated and presented as cumulative odds ratios (ORs).RESULTS: Sixteen studies (n = 3958 patients) comparing EBRT versus no EBRT, including one randomized controlled trial (RCT) in extremity sarcoma, were analyzed. EBRT appeared to reduce LR in both retroperitoneal tumors (OR 0.47, p < 0.0001) and other locations (OR 0.49, p = 0.001). OS was improved by EBRT in retroperitoneal STSs (OR 0.37, p < 0.0001) but not in other tumor locations. Eleven studies (n = 2140), including one RCT, compared preoperative and postoperative radiotherapy. LR was less frequent following preoperative EBRT in retroperitoneal STSs (OR 0.03, p = 0.02), as well as in other tumor locations (OR 0.67, p = 0.01), while wound complications in extremity sarcoma were more frequent following preoperative EBRT (OR 2.92, p < 0.0001). Several studies included in this meta-analysis bear a high risk of bias and no RCT has been published for retroperitoneal STS.CONCLUSIONS: This meta-analysis supports the use of EBRT for local tumor control in patients with resectable STSs. Based on a small number of non-randomized studies, a positive effect on OS may exist in the subgroup of retroperitoneal STSs.

AB - PURPOSE: The aim of this study was to evaluate the role of preoperative and postoperative external beam radiation therapy (EBRT) in the treatment of resectable soft tissue sarcomas (STSs) of different tumor locations.METHODS: A systematic literature search was performed to identify studies investigating the effects of EBRT (versus no EBRT) on local recurrence (LR) and overall survival (OS) or comparing different EBRT sequences. Random effects meta-analyses were calculated and presented as cumulative odds ratios (ORs).RESULTS: Sixteen studies (n = 3958 patients) comparing EBRT versus no EBRT, including one randomized controlled trial (RCT) in extremity sarcoma, were analyzed. EBRT appeared to reduce LR in both retroperitoneal tumors (OR 0.47, p < 0.0001) and other locations (OR 0.49, p = 0.001). OS was improved by EBRT in retroperitoneal STSs (OR 0.37, p < 0.0001) but not in other tumor locations. Eleven studies (n = 2140), including one RCT, compared preoperative and postoperative radiotherapy. LR was less frequent following preoperative EBRT in retroperitoneal STSs (OR 0.03, p = 0.02), as well as in other tumor locations (OR 0.67, p = 0.01), while wound complications in extremity sarcoma were more frequent following preoperative EBRT (OR 2.92, p < 0.0001). Several studies included in this meta-analysis bear a high risk of bias and no RCT has been published for retroperitoneal STS.CONCLUSIONS: This meta-analysis supports the use of EBRT for local tumor control in patients with resectable STSs. Based on a small number of non-randomized studies, a positive effect on OS may exist in the subgroup of retroperitoneal STSs.

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DO - 10.1245/s10434-017-6081-2

M3 - Article

C2 - 28895107

VL - 25

SP - 754

EP - 767

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 3

ER -