The following is a summary of “Radiation therapy for retroperitoneal sarcoma: practice patterns in North America,” published in the March 2024 issue of Oncology by Ruff et al.

The incorporation of radiation therapy (RT) into the management of retroperitoneal sarcoma (RPS) poses a dilemma within the medical community. This study sought to investigate the evolving practice patterns concerning RT utilization among patients diagnosed with RPS within a comprehensive, nationwide cohort.

Researchers thoroughly analyzed data from the National Cancer Database spanning 2004 to 2017, focusing on patients who underwent surgical resection for RPS. Trends in RT utilization over time were meticulously assessed, employing contingency tables alongside the Cochran-Armitage Trend test for statistical analysis.

Among the 7,485 patients who underwent surgical resection, 1,821 (24.3%) received RT, with a distribution of 59.9% in the adjuvant setting and 40.1% in the neoadjuvant setting. Notably, there was a marginal annual decline in RT utilization by less than 1% (p = 0.0178). Intriguingly, the investigators observed a yearly increase of neoadjuvant RT by 13%, juxtaposed against a corresponding decrease of adjuvant RT by 6% on average (p < 0.0001). Factors associated with the administration of neoadjuvant RT included treatment at high-volume centers (OR 14.795, p < 0.0001) and tumors exceeding 10 cm in size (OR 2.009, p = 0.001). Conversely, the presence of liposarcomas correlated with the provision of adjuvant RT (OR 0.574, p = 0.001). Importantly, no statistically significant difference in overall survival was observed between patients managed with surgery alone versus those who underwent combined surgical and RT interventions (p = 0.07).

Their investigation reveals a discernible decline in RT utilization for RPS in the United States over the years, coupled with a notable shift towards neoadjuvant RT. Nonetheless, many patients still receive adjuvant RT, predominantly within low-volume hospital settings. These findings underscore the ongoing evolution of treatment paradigms for RPS, emphasizing the need for further research to delineate optimal therapeutic strategies and ensure equitable access to high-quality care across all patient cohorts.

Source: ro-journal.biomedcentral.com/articles/10.1186/s13014-024-02407-8