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Randomised Trial of Volume of Post-operative Radiotherapy Given to Adult Patients With eXtremity Soft Tissue Sarcoma

Phase 3
Completed
Conditions
Sarcoma
Interventions
Radiation: radiotherapy
Registration Number
NCT00423618
Lead Sponsor
Sheffield Teaching Hospitals NHS Foundation Trust
Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Giving radiation therapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether giving radiation therapy to a smaller area of tissue surrounding the tumor is as effective as giving radiation therapy to a wider area of tissue surrounding the tumor in treating soft tissue sarcoma.

PURPOSE: This randomized phase III trial is studying giving external-beam radiation therapy to a small area of tissue surrounding the tumor to see how well it works compared with giving external-beam radiation therapy to a wider area of tissue surrounding the tumor in treating patients who have undergone surgery for soft tissue sarcoma of the arms, hands, legs, or feet.

Detailed Description

OBJECTIVES:

Primary

* Determine if reduced volume adjuvant radiotherapy increases limb function without compromising local control in patients with previously resected extremity soft tissue sarcoma.

Secondary

* Determine the toxicity of this regimen in these patients.

* Determine the overall level of disability in patients treated with this regimen.

* Determine the disease-free survival and overall survival of these patients.

OUTLINE: This is a randomized, controlled, prospective, multicenter study. Patients are stratified according to tumor grade (1 vs 2 vs 3), adequacy of surgical clearance (R0 vs R1), and treatment center. Patients are randomized to 1 of 2 treatment arms.

* Arm I (control): Patients undergo external beam radiotherapy (EBRT), including full margins, once daily 5 days a week for 6½ weeks .

* Arm II: Patients undergo EBRT as in arm I but only reduced margins are included.

After completion of study treatment, patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 400 patients will be accrued for this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
216
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Research armradiotherapyRadiotherapy Research arm A total of 33 fractions each of 2Gy should be given once a day for 5 days per week over 6 weeks and 3 days in week 7, totalling 66Gy. The 66Gy in 33 fractions will be delivered to CTV2 alone. No attempt will be made to include drain/biopsy sites or the surgical scar.
Control armradiotherapyRadiotherapy Conventional treatment arm A total of 33 fractions each of 2Gy should be given once a day for 5 days per week over 6 weeks and 3 days in week 7, totalling 66Gy. The first 50 Gy in 25 fractions will be given to CTV1 and subsequent 16 Gy in 8 fractions will be delivered to CTV2.
Primary Outcome Measures
NameTimeMethod
Limb functionality as measured by the Toronto Extremity Salvage Score (TESS)2 years
Time to local recurrencetime from randomisation into the trial to the occasion when a local recurrence is confirmed by biopsy. For those patients who are not observed to have a local recurrence during the course of the study, the time to local recu
Secondary Outcome Measures
NameTimeMethod
Disease-free survivaldefined in whole days as time from randomisation into the trial to either local or distant recurrence or death (whichever occurs first).
Overall level of disability as measured by the TESS questionnaire2 years
Soft tissue and bone toxicity as measured by RTOG2 years
Overall survivaldefined in whole days as time from randomisation into the trial to death.

Trial Locations

Locations (6)

Royal Orthopedic Hospital NHS Trust

🇬🇧

Birmingham, England, United Kingdom

Mount Vernon Cancer Centre at Mount Vernon Hospital

🇬🇧

Northwood, England, United Kingdom

Christie Hospital

🇬🇧

Manchester, England, United Kingdom

Nottingham City Hospital

🇬🇧

Nottingham, England, United Kingdom

North Glasgow University Hospitals NHS Trust

🇬🇧

Glasgow, United Kingdom

Cancer Research Centre at Weston Park Hospital

🇬🇧

Sheffield, England, United Kingdom

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