Evidence map›Paper›PMID 38778821›Full record

ArticleAdvances in radiation oncology2024

Novel Definitive Hypofractionated Accelerated Radiation Dose-painting (HARD) for Unresected Soft Tissue Sarcomas.

John Michael Bryant, Matthew N Mills, George Q Yang, Casey Liveringhouse, Russell Palm, Peter A Johnstone, Justin T Miller, Kujtim Latifi, Vladimir Feygelman, Arash O Naghavi

Abstract read
In one paragraph

Article in Advances in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

John Michael BryantDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Matthew N MillsDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
George Q YangDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Casey LiveringhouseDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Russell PalmDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Peter A JohnstoneDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Justin T MillerDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Kujtim LatifiDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Vladimir FeygelmanDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Arash O NaghaviDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Soft tissue sarcomas (STS) are historically radioresistant, with surgery being an integral component of their treatment. With their low α/β, STS may be more responsive to hypofractionated radiation therapy (RT), which is often limited by long-term toxicity risk to surrounding normal tissue. An isotoxic approach using a hypofractionated accelerated radiation dose-painting (HARD) regimen allows for dosing based on clinical risk while sparing adjacent organs at risk. Methods and Materials: We retrospectively identified patients from 2019 to 2022 with unresected STS who received HARD with dose-painting to high, intermediate, and low-risk regions of 3.0 Gy, 2.5 Gy, and 2.0 to 2.3 Gy, respectively, in 20 to 22 fractions. Clinical endpoints included local control, locoregional control, progression free survival, overall survival, and toxicity outcomes. Results: Twenty-seven consecutive patients were identified and had a median age of 68 years and tumor size of 7.0 cm (range, 1.2-21.0 cm). Tumors were most often high-grade (70%), stage IV (70%), located in the extremities (59%), and locally recurrent (52%). With a median follow-up of 33.4 months, there was a 3-year locoregional control rate of 100%. The 3-year overall and progression-free survival were 44.9% and 23.3%, respectively. There were 5 (19%) acute and 2 (7%) late grade 3 toxicities, and there were no grade 4 or 5 toxicities at any point. Conclusions: The HARD regimen is a safe method of dose-escalating STS, with durable 3-year locoregional control. This approach is a promising alternative for unresected STS, though further follow-up is required to determine long-term control and toxicity.

Identifiers

PMID38778821
PMCPMC11110037

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.