title: Prospective clinical study of pre-operative SIB-IMRT in preparing surgical boundary of extremity soft tissue sarcoma.
abstract: OBJECTIVE
  To establish the pre-operative simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) technology in preparing the surgical boundary of extremity soft tissue sarcoma (ESTS), aiming to investigate its impacts towards the short-term local control and post-operative wound complications of ESTS.
  
  
  METHODS
  16 patients with local advanced ESTS were prospectively collected and performed the SIB-IMRT technology to prepare the surgical boundary. The resection surgery was completed within 3-6 weeks after the radiotherapy. The efficacy was evaluated according to the changes of limb circumference, RECIST criteria and relapse-free survival; and the CTCAE 4.0 standard was used to evaluate the considerations of post-radiotherapy acute radiative skin injury.
  
  
  RESULTS
  The radiotherapeutic plan of pre-operative SIB-IMRT technology in preparing the surgical boundary of locally advanced ESTS was developed. Before and after SIB-IMRT, the difference of limb circumference was statistically significant (p <0.05); after SIB-IMRT, 13 cases exhibited the decreased lesions, 7 cases exhibited the partial remission (PR), and 9 cases showed the stable lesions (SD); the median time of recurrence-free survival was 6.5 months, the efficiency of pre-operative SIB-IMRT was > 60%, with 13 cases of level 1 acute radiative skin injury, 2 cases of level 2 and 1 case of level 3.
  
  
  CONCLUSIONS
  The pre-operative SIB-IMRT was feasible, safe and effective in preparing the surgical boundary of locally advanced ESTS, which could reduce the tumor volume, and improve the short-term relapse-free survival time.
authors.affiliation: Department of Bone and Soft Tissue, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, Xinjiang, China. bjingpingxj@163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.forename: P-M
authors.initials: PM
authors.lastname: Xie
authors.forename: C
authors.initials: C
authors.lastname: Dong
authors.forename: S-L
authors.initials: SL
authors.lastname: Xu
authors.forename: M
authors.initials: M
authors.lastname: Zhou
authors.forename: J-P
authors.initials: JP
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003198:Computer Simulation; D005121:Extremities; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011300:Preoperative Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012509:Sarcoma / Q000532:radiotherapy* / Q000601:surgery; D055815:Young Adult