title: High-dose pre-operative helical tomotherapy (54 Gy) for retroperitoneal liposarcoma.
abstract: OBJECTIVE
  To evaluate the feasibility of pre-operative radiotherapy (54 Gy) with Helical Tomotherapy (HT) followed by surgery.
  
  
  METHODS
  Ten patients with non-metastatic resectable retroperitoneal liposarcomas were treated by pre-operative tomotherapy (54 Gy) and surgery. Clinical and biological toxicities were evaluated on the CTCAEV3.0 scale. For nine patients, delivered tomotherapy plans were compared with retrospectively-planned dynamic intensity-modulated radiotherapy (IMRT) dosimetric studies.
  
  
  RESULTS
  No immediate or late Grade>2 toxicities were observed after radiotherapy. Post-operatively, one patient died and three patients experienced Grade 3 toxicity (two digestive and one metabolic). These toxicities disappeared and only two patients presented persistent Grade 1 paresthesia. R0 resection was obtained for four patients, R1 for four, and R2 resection for two. With a median follow-up of 26 months, no local or metastatic relapse was observed. Dosimetric comparisons between HT and retrospectively-planned IMRT demonstrate adequate target volume coverage for both techniques. Gastrointestinal sparing is higher with HT with a D200cc reduced by 5 Gy. Integral dose (ID) was increased in HT.
  
  
  CONCLUSIONS
  High dose pre-operative radiotherapy (54 Gy) for retroperitoneal liposarcoma is feasible and mostly well tolerated. Cumulative toxicity and tolerance depend mainly on patient's general status. Image-guided radiation therapy (IGRT) is essential, irrespective of the IMRT technique used. Furthermore, HT offers the possibility of sparing selected areas in such complex volumes.
authors.affiliation: Department of Radiation Oncology, Institut Bergonié, Bordeaux, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Sargos
authors.forename: Catherine
authors.initials: C
authors.lastname: Dejean
authors.forename: Bénédicte Henriques
authors.initials: BH
authors.lastname: de Figueiredo
authors.forename: Véronique
authors.initials: V
authors.lastname: Brouste
authors.forename: Binh
authors.initials: B
authors.lastname: Nguyen Bui
authors.forename: Antoine
authors.initials: A
authors.lastname: Italiano
authors.forename: Eberhard
authors.initials: E
authors.lastname: Stoeckle
authors.forename: Guy
authors.initials: G
authors.lastname: Kantor
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008080:Liposarcoma / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome