Toxicity, normal tissue and dose-volume planning parameters for radiotherapy in soft tissue sarcoma of the extremities: A systematic review of the literature.
Date
2023-09-01ICR Author
Author
Simões, R
Augustin, Y
Gulliford, S
Dehbi, H-M
Hoskin, P
Miles, E
Harrington, K
Miah, AB
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Patients with soft tissue sarcoma of the extremities (STSE) are left with high incidence of toxicities after Radiotherapy (RT). Understanding the normal tissue dose relationship with the development of long-term toxicities may enable better RT planning in order to reduce treatment toxicities for STSE. This systematic review of the literature aims at reporting the incidence of acute and late toxicities and identifying RT delineation guidance the normal tissues structures and dose-volume parameters for STSE. METHODS: A literature search of PUBMED-MEDLINE for studies that reported data on RT toxicity outcomes, delineation guidelines and dose-volume parameters for STSE from 2000 to 2022. Data has been tabulated and reported. RESULTS: Thirty of 586 papers were selected after exclusion criteria. External beam RT prescriptions ranged from 30 to 72 Gy. The majority of studies reported the use of Intensity Modulated RT (IMRT) (27%). Neo-adjuvant RT was used in 40%. The highest long-term toxicities were subcutaneous and lymphoedema, reported when delivering 3DCRT. IMRT had a lower incidence of toxicities. Normal tissue outlining such as weight-bearing bones, skin and subcutaneous tissue, corridor and neurovascular bundle was recommended in 6 studies. Nine studies recommended the use of dose-volume constraints, but only one recommended evidence-based dose-volume constraints. CONCLUSION: Although the literature is replete with toxicity reports, there is a lack of evidence-based guidance on normal tissue and dose-volume parameters and strategies to reduce the normal tissues irradiation when optimising RT plans for STSE are poor compared to other tumour sites.
Collections
Subject
Dose-volume constraints
Normal tissue toxicities
Radiotherapy
Soft tissue sarcoma of the extremities
Humans
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Sarcoma
Radiotherapy, Intensity-Modulated
Extremities
Research team
Targeted Therapy
Language
eng
Date accepted
2023-06-07
License start date
2023-09-01
Citation
Radiotherapy and Oncology, 2023, 186 pp. 109739 -
Publisher
ELSEVIER IRELAND LTD
Except where otherwise noted, this item's license is described
as
http://creativecommons.org/licenses/by/4.0/
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