A new clinical practice guideline from the American Society for Radiation Oncology (ASTRO), published in Practical Radiation Oncology, provides evidence-based recommendations regarding radiation therapy (RT) for adults with soft tissue sarcoma (STS). The authors address five questions related to the use of RT for STS, including considerations for sequencing of RT with respect to surgery and the role of RT in management of retroperitoneal sarcoma. They recommend multidisciplinary evaluation and decision making for all cases of STS. For patients with an increased risk for local recurrence of resected STS, RT is recommended, especially if close or microscopically positive margins are anticipated or have occurred. Preoperative RT is strongly recommended over postoperative RT when RT is indicated. Routine RT use in addition to oncologic resection is conditionally not recommended for primary localized retroperitoneal sarcoma. Finally, when RT is used for certain cases of retroperitoneal sarcoma, preoperative, but not postoperative, RT is recommended. “This guideline stresses the importance of multidisciplinary input prior to initiation of treatment and provides detailed recommendations on indications for radiation therapy, dose, and planning techniques,” the authors said in a statement. “ASTRO developed this guideline to provide clear guidance on the role of radiation therapy in patient-centered, multidisciplinary oncologic care.”
COVID-19 Immune Response Appears Strong in Cancer Patients
The seropositivity rate among patients with cancer remains high 4 months after the second dose of the COVID-19 vaccine, according to a research letter published in JAMA Oncology. Investigators assessed the antispike (anti-S) IgG antibody response to the mRNA vaccine in 95 patients with cancer versus 66 controls approximately 4 months after the second vaccine dose. After a median of 123 days from the second vaccination, 87% of patients with cancer and 100% of controls were seropositive for anti-S IgG antibodies. In patients with cancer, median titer levels were significantly lower than in the control group (417 vs 1,220 arbitrary units per milliliter). Median IgG titers varied 3.6-fold by tumor type and 8.8-fold by anticancer treatment type, with the lowest titers observed for immunotherapy plus chemotherapy and biological therapy. “Long-term cellular memory could call into question the need for a third booster dose,” the authors wrote.