title: Neoadjuvant radiotherapy for retroperitoneal sarcoma: A systematic review.
abstract: OBJECTIVE
  The multi-modal treatment of retroperitoneal sarcoma has seen increased use of neoadjuvant radiation. However, its effect on local recurrence and survival remain controversial. We aimed to synthesize and evaluate the literature.
  
  
  METHODS
  The review was conducted according the recommendation of the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) group with pre-specified inclusion and exclusion criteria.
  
  
  RESULTS
  Of 8,701 citations collected, 15 articles reported on 464 patients. The median age was 56 years (45-64). The predominant histological subtypes were liposarcoma (51.54%) and leiomyosarcoma (23.26%). Tumor differentiation composed of 37.1% well-, 12.8% moderate-, 46.0% poorly-, and 4.1% undifferentiated. Most studies featured external beam radiation therapy (EBRT) treatment regimen with some who included patients treated with IMRT instead. Median follow-up averaged 41.4 months (19-106 months). Median 5-year OS, PFS, and LRR rates were 58%, 71.5%, and 25%. Using the NCI CTCAE, toxicities from Grade 1 (Mild) through Grade 5 (death) were experienced by 18.8%, 10.2%, 16.3%, 0.7%, and 1.6% of patients.
  
  
  CONCLUSIONS
  NART is a safe to use for RPS, but its effect toward survival and local control remains unclear. Without randomized control trials, common reporting criteria for pro- and retrospective studies are needed to allow comparison between studies. J. Surg. Oncol. 2016;113:628-634. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Hao
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: John T
authors.initials: JT
authors.lastname: Miura
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mona
authors.initials: M
authors.lastname: Lalehzari
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Rahul
authors.initials: R
authors.lastname: Rajeev
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Donahue
authors.affiliation: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Meena
authors.initials: M
authors.lastname: Bedi
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Turaga
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Fabian M
authors.initials: FM
authors.lastname: Johnston
mesh_terms: D006801:Humans; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome
keywords: cancer; intensity-modulated; neoadjuvant radiotherapy; neoplasms; radiotherapy; retroperitoneal sarcoma