Table 3 The table summarizes major published studies on preoperative conventionally fractionated RT

Lansu et al. [65]

2021 Nether-lands

Phase II multi-center trial

Localized extremity or trunk MLPS

79

45

44: 56

N/A

LE: 91%

UE: 3%

Trunk: 6%

9.9 cm

18 × 2 Gy = 36 Gy

CTV = GTV + 3 cm long.; + 1.5 cm all other directions

PTV = CTV + 1 cm

36 Gy/54 Gy

IMRT

No

 ≥ 4 weeks

25

95%

3 yrs

N/A

100%

N/A

N/A

Overall WC; 22%

2°: 11%

3°: 3%

Lansu et al. [66]

2019 Nether-lands

Retrosp. analysis

Localized extremity STS

191

60

♀ n = 88

♂ n = 103

G1: n = 14

G2: n = 76

G3: n = 79

N/A: n = 22

LE: 92%

UE: 8%

N/A

25 × 2 = 50 Gy (85% of pts)

CTV = GTV + 4 cm long.; + 1.5 cm all other directions

PTV = CTV + 1 cm

50 Gy/75 Gy

EBRT

No

6 weeks (median)

21

70% 5 yrs

5%

93% 5 yrs

N/A

N/A

Overall WC: 31%

N/A

Wang et al. [35]

2015 USA

Phase II multi-center trial

Localized extremity STS, < 32 cm

86

61

53: 47

G1: 16.5%

G2: 26.6%

G3: 48.1%

LE: 78.5%

UE: 13.9%

Other: 7.6%

10.5 cm

25 × 2 Gy = 50 Gy

PTV = CTV + 0.5 cm

 ≥ 8 cm diameter or G2/G3: CTV = GTV + 3 cm long.; + 1.5 cm radial

 < 8 cm diameter or G1

CTV = GTV + 2 cm long., 1 cm radial

50 Gy/75 Gy

IG-IMRT 74.7%

3DCRT 25.3%

No

4–8 weeks

3.6 yrs

80.6% 2 yrs

N/A

94% 2 yrs

N/A

N/A

Major WC: 36.6%

 ≥ 2°: 10.5% at 2 yrs

O’Sullivan et al. [67]

2013 Canada

Phase II single center trial Localized lower extremity STS

59

56 (mean)

♀n = 29 ♂n = 30

G1: n = 4

G2: n = 26

G3: n = 29

LE only

9.5 cm

25 × 2 Gy = 50 Gy

CTV = GTV + 4 cm long. + 1.5 cm radial

PTV = CTV + 0.5 cm

50 Gy/75 Gy

IG-IMRT

No

N/A

49

N/A

6.8%

N/A

88.2% 5 yrs

N/A

Major WC: 30.5%

No > 2° toxicity

Hui et al. [68]

2006 Australia

Retrosp. analysis

Localized extremity or trunk wall STS

67

52

♀n = 26 ♂n = 41

G1: n = 19

G2/G3: n = 46

N/A: n = 2

LE: n = 53

UE: n = 9

Trunk: n = 5

6 cm

28 × 1.8 Gy = 50.4 Gy

PTV = GTV + 6 cm long.

48.72 Gy/73.08 Gy

EBRT

n = 3 pts: doxo post op

33 days (median)

4.1 yrs

73% 5 yrs

9%

N/A

93% 5 yrs

N/A

3°: Dermatitis: 6%

overall WC: 41%

Overall: n = 5 pts

Kraybill et al. [69]

2006 USA

Phase II multi-center trial

G2–G3 extremity and trunk wall sarcoma, ≥ 8 cm, ≤ 4 lung metastases

64

45.5

44: 56

G2: 20%

G3: 80%

Extremity 88%

Torso: 12%

15 cm

22 × 2 Gy interdigitated = 44 Gy

PTV = GTV + 9 cm long. +  ≥ 2 cm radial

44 Gy/66 Gy

EBRT

MAID

80 days after day 1 of CTX

6.1 yrs

75.1% 3 yrs

17.6% 3 yrs

N/A

N/A

56.6% 3 yrs

3°: Hematological: 13%

Nonhematological: 28%

4°: Overall: 84%

5°: Overall: 5%

Late toxicity: N/A

Zagars et al. [70]

2003 USA

Retrosp. Analysis

Localized, G1–G3 STS

271 pre op

N/A

N/A

G1: 4%

G2: 26%

G3: 70%

LE: 59%

UE: 14%

Other: 27%

8 cm

Median single dose: 2.0 Gy

Median total dose: 50 Gy

50 Gy/75 Gy

EBRT

doxo

4–6 weeks

6.4 yrs

N/A

N/A

85% 5 yrs

83% 10 yrs

N/A

N/A

N/A

5%

O’ Sullivan et al. [25, 26] and Davis et al. [24]

2002 Canada

Phase III multi-center RCT

Localized, extremity STS

94 pre op

 < 50: 34%

 ≥ 50– < 70: 43%

 ≥ 70: 23%

45: 55

G1: 17%

G2–G3: 83%

LE: 80%

UE: 20%

 ≤ 10 cm 65%

 > 10 cm 35%

Pre op: 25 × 2 Gy = 50 Gy (n = 88 pts)

Additional post op boost 8 × 2 Gy = 16 Gy (n = 14 pts)

pre op PTV = GTV + 5 cm long.

Post op boost: PTV = GTV + 2 cm

Pre op: 50 Gy/75 Gy

post op boost: 16 Gy/24 Gy

EBRT

No

3–6 weeks

3.3 yrs

73%

N/A

93% 5 yrs

58% 5 yrs

N/A

Major WC: 35%

 ≥ 2°:

Fibrosis: 31.5% Joint stiffness: 17.8%

Edema: 15.1%

Pollack et al. [71]

1998 USA

Retrosp. analysis

G2–G3 pleom. sarcoma, liposarcoma, synovial sarcoma

128 pre op

54 (mean)

58: 42

G2: 32.8%

G3: 67.2%

LE + UE: 82%

Other: 18%

10 cm (mean)

25 × 2 Gy = 50 Gy

PTV = GTV + 5–7 cm long. + 2–3 cm radial

50 Gy/75 Gy

3D-CRT

doxo, CP, DTIC, VCR

N/A

97

N/A

N/A

82% 5 yrs

N/A

N/A

Acute WC: 25% (pre op)

6.2% (entire cohort)