Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Perioperative radiation therapy underused in elderly patients with soft tissue sarcomas

Venigalla S et al. Intl J Rad Oncology*Biology*Physics; September (102) 2018: 155-165. https://doi.org/10.1016/j.ijrobp.2018.05.019

Key clinical point: Perioperative radiation therapy is underused in patients age 70 and older with high-grade STS even though radiation therapy is associated with improved overall survival, and the effect is more notable in elderly patients.

Major finding: Of 6,978 elderly patients, 3549 (51%) underwent surgery alone, and 740 (11%) and 2,679 (38%) received pre- and postoperative radiation therapy, respectively. Elderly patients received radiation therapy less commonly than did nonelderly patients (49% vs 52%, P < .001) despite presenting with higher grade tumors (grade 3, 86% vs 80%, P less than .001) and experiencing more frequent positive surgical margins (23% vs 16%, P less than .001). Preoperative (hazard ratio = 0.64, 95% confidence interval: 0.54–0.77, P < .001) and postoperative (hazard ratio = 0.72, 95% confidence interval: 0.67–0.77, P < .001) radiation therapy was associated with improved overall survival compared with surgery alone. Radiation therapy use resulted in a greater magnitude of 5-year relative survival improvement in elderly than in nonelderly patients.

Study details: Patients age 70 or more with high-grade STS who underwent surgery with or without perioperative radiation therapy from 2004 to 2013 were identified from the National Cancer Database. A cohort under age 70 was identified for secondary comparative analyses.

Disclosures: The authors had no relevant disclosures.

Source: Venigalla S et al. Intl J Rad Oncology*Biology*Physics; September (102) 2018: 155-165. https://doi.org/10.1016/j.ijrobp.2018.05.019

Citation:

Venigalla S et al. Intl J Rad Oncology*Biology*Physics; September (102) 2018: 155-165. https://doi.org/10.1016/j.ijrobp.2018.05.019

This Week's Must Reads

Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005

TAO: Nonwhite ethnicity, limb infection predict poor prognosis, Le Joncour A et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 1885

Thrombolysis for acute ischemic stroke safe in GI malignancy, Inohara T et al. Circulation. 2018 Nov 6;138[suppl 1], Abstract A12291

Ten years of anastrozole boosts disease-free survival, Ohtani S et al. SABCS 2018, Abstract GS3-04

Must Reads in Sarcoma & GIST

Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005

Expanded genetic analyses of myxofibrosarcomas may guide precision therapies, Ogura K et al. Nature Communications; 17 July 2018. https://doi.org/10.1038/s41467-018-03891-9

Malignant tenosynovial giant cell tumors appear to originate from synoviocytes, Al-Ibraheemi A et al. Modern Pathology; 11 Sept. 2018. https://doi.org/10.1038/s41379-018-0129-0

Type and rate of clonal evolution vary widely in sarcoma pathogenetic subgroups, Hofvander J et al. Nature Communications 10 Sept. 2018. https://doi.org/10.1038/s41467-018-06098-0

Increasing pannexin 1 levels might be a novel treatment for rhabdomyosarcoma , Xiang X et al. Oncogenesis; 21 Nov. 2018. https://doi.org/10.1038/s41389-018-0100-4