The benefit for radiotherapy at specialised sarcoma centres: a systematic review and clinical practice guidelines from the Australia and New Zealand Sarcoma Association

Angela M. Hong*, Helen Lo, Anna Lawless, Deborah Zhou, Susie Bae, Marianne Phillips, Fiona Maclean, Jayesh Desai, Jasmine Mar, Smaro Lazarakis, David Pryor, Stephen R. Thompson, Australia and New Zealand Sarcoma Association Guidelines Working Party

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)

Abstract

Patients with sarcoma are best managed at specialised sarcoma centres as supported by published literature. Optimal management requires multidisciplinary team input to formulate the diagnosis and treatment sequencing taking into consideration multiple clinical and pathologic factors. This systematic review aimed to evaluate the impact on outcomes of radiotherapy at specialised sarcoma centres. A systematic review was conducted using the population, intervention, comparison and outcome model. A literature search was performed using Medline, Embase, Cochrane Central databases for publications from 1990 to February 2022 that evaluated the local control, survival and toxicity of radiotherapy at specialised sarcoma centres. A total of 21 studies were included (17 cancer registry studies, four retrospective comparative studies). Four studies reported the local recurrence endpoint when radiotherapy was part of limb conservation treatment and showed better conformity to clinical practice guidelines and an improved local recurrence free rate when radiotherapy treatment is supported through, but may not be necessarily delivered at a specialised sarcoma centres. Only one retrospective study analysed toxicity specifically and demonstrated that patients who received preoperative radiotherapy at community centres compared to radiotherapy at a specialised sarcoma centre were more likely to develop a major wound complication. Fourteen studies reported overall survival, and 12 of these showed significantly better 5-year overall survival for patients managed at specialised sarcoma centres, however the specific impact of radiotherapy delivered at sarcoma centres could not be determined. In conclusion, patients with sarcoma should be managed through specialised sarcoma centres for better oncological outcomes. Radiotherapy in specialised sarcoma centre is associated with a lower rate of wound complications and may contribute to improved oncological outcomes as part of the limb conservation treatment at a specialised sarcoma centre.

Original languageEnglish
Pages (from-to)158-162
Number of pages5
JournalRadiotherapy and Oncology
Volume177
DOIs
Publication statusPublished - Dec 2022

Keywords

  • Bone sarcoma
  • high volume
  • Multidisciplinary
  • Radiotherapy
  • Sarcoma
  • Soft tissue sarcoma
  • Specialised

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