Management of Recurrent Liposarcoma with Fractionated Stereotactic Radiotherapy: A Case Report

Year 2012, , 42 - 45, 01.04.2012

Gülhan Güler Avcı Yıldız Yükselen Güney Süheyla Aytaç Arslan Ela Delikgöz Soykut Gonca Altınışık İnan

https://doi.org/10.5505/aot.2012.83803

Abstract

In this case report tumor control was evaluated with only radiotherapy without surgery in the management of recurrent liposarcoma. Recurrent mass on the left posterior thigh was developed in 40 years old woman whom surgery was performed without adjuvant chemotherapy for an initial stage of T2bN0M0 well-differentiated liposarcoma, 5 years after surgery. Magnetic resonance imaging (MRI) showed signs of recurrent mass (38x32x15mm) in initial location. The patient was referred to our center for radiotherapy, since she did not accept surgery. We performed fractioned stereotactic radiotherapy (FSRT) with CyberKnife® (Accuray Inc., Sunnyvale, CA), for recurrent tumor and external beam radiation therapy (EBRT) for the microscopic tumor around the recurring mass. At 49 months follow-up MRI showed down sizing of tumor by 40 %. FSRT and/or EBRT may be a promising in terms of treatment alternative but this should be confirmed by more studies

Keywords

Cyberknife, Stereotactic radiotherapy; Recurrent liposarcoma

Rekürren Liposarkomda Fraksiyone Stereotaktik Radyoterapi Uygulaması: Olgu Sunumu

Abstract

Bu olgu sunumunda nüks liposarkom tedavisinde farklı olarak cerrahi yapılmaksızın tek başına radyoterapi ile tümör kontrolü değerlendirilmiştir. İlk evresi T2bN0M0 olan iyi differansiye liposarkom tanılı, primer cerrahi uygulanan ve adjuvan radyoterapi uygulanmayan 40 yaşında kadın hastanın sol uyluk posteriorunda 5 yıl sonra nüks kitle gelişti. Nüks kitle için fraksiyone stereotaktik radyoterapi (FSRT) CyberKnife® (Accuray Inc., Sunnyvale, CA) ve mikroskopik hastalık için eksternal radyoterapi (ERT) uygulandı. Standart tedavi şekillerinin uygun olmadığı durumlarda FSRT ve/veya ERT tedavi alternatifi açısından umut verici olabilir, ancak daha çok çalışma ile desteklenmelidir.

Keywords

Cyberknife, Stereotaktik Radyoterapi; Rekürren Liposarkom

References

• Aksoy B, Aksoy HM. Bacakta sekonder deri tutulumlu rekürren miksoid liposarkom: Olgu sunumu. Genel Tıp Dergisi 2009;19:33-5
• Ng YC, Tan MH. Liposarcoma of the extremities: a review of the cases seen and managed in a major tertiary hospital in Singapore. Singapore Med J 2009;50:857-61
• Shiu MH, Chu F, Castro EB, Hajdu SI, Fortner JH. Results of surgical and radiation therapy in the treatment of liposarcoma arising in an extremity. Am J Roentgenol Radium Ther Nucl Med 1975;123:577-82
• Yang JC, Chang AE, Baker AR, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998;16:197-203
• Pisters PW, Harrison LB, Woodruff JM, Gaynor JJ, Brennan MF. A prospective randomized trial of adjuvant brachytherapy in the management of low- grade soft tissue sarcomas of the extremity and superficial trunk. J Clin Oncol 1994;12:1150-5
• Brennan MF, Casper ES, Harrison LB, Shiu MH, Gaynor J, Hajdu SI. The role of multimodality therapy in soft-tissue sarcoma. Ann Surg 1991;214:328-36
• Moureau-Zabotto L, Thomas L, Bui BN, Chevreau C, Stockle E, Martel P. Management of soft tissue sarcomas (STS) in first isolated local recurrence: a retrospective study of 83 cases. Radiother Oncol 2004;73:313-9
• Tepper JE, Suit HD. Radiation therapy alone for sarcoma of soft tissue. Cancer 1985;56:475-9
• Dickie CI, Griffin AM, Parent AL, et al. The relationship radiotherapy treatment volume for soft tissue sarcomas treated with external beam radiotherapy and function preservation surgery. Int J Radiat Oncol Biol Phys 2012;82:1528-34 and
• Wulf J, Hadinger U, Oppitz U, Thiele W, Flentje M. Stereotactic boost irradiation for targets in the abdomen and the pelvis. Radiother Oncol 2004;70:31-6