K.E. Haglund

The role of modern radiation therapy in the management of extremity sarcomas

For nearly half a decade, surgery and radiation therapy have been used in combination to achieve the goal of limb preservation in extremity soft tissue sarcoma, with success rates in excess of 90%. Common decision points in therapeutic radiation delivery for sarcoma are discussed, including preoperative versus postoperative irradiation, the postoperative boost, and when irradiation might be unnecessary. We describe specialized techniques, such as brachytherapy and intraoperative irradiation. The data driving current practice is summarized. J. Surg. Oncol. 2015 111:599–603.

Patterns of major wound complications following multidisciplinary therapy for lower extremity soft tissue sarcoma

The purpose of this study was to determine the pattern and timing of major wound complications (MWCs) in patients at our institution who received multimodality treatment for lower extremity soft tissue sarcoma (LE‐STS) and to evaluate the impact of MWCs on tumor control and patient outcomes.

Minimal Inter-Fractional Fiducial Migration during Image-Guided Lung Stereotactic Body Radiotherapy Using SuperLock Nitinol Coil Fiducial Markers

Objectives Stereotactic body radiotherapy (SBRT) is being increasingly used for the treatment of patients with lung cancer or lung metastasis who are medically unfit to undergo resection. In order to improve accuracy and confidence in targeting tumors, many centers rely on fiducial implantation. We evaluated the migration of a novel fiducial marker specifically designed for lung tissue implanted via electromagnetic navigation bronchoscopy (ENB). Methods We retrospectively quantified the individual and group migrations of SuperLock nitinol coil fiducials for 15 patients receiving lung stereotactic body radiotherapy (SBRT), in order to evaluate the reliability of using these fiducials as a target surrogate for cases where tumors cannot be clearly delineated on cone beam CTs (CBCTs). For each fraction, we compared the individual and group migrations of the fiducials between the planning CT and the acquired CBCT. The group migration was defined as the distance between the centroids of the fiducial group and GTV. Results A total of 16 lung targets were included in our study for these 15 patients (one patient with two targets). Of 55 fiducials placed, we observed a 100% retention rate. The mean individual migration was 1.87 mm (range, 0.63–5.25 mm) with a standard deviation of 1.26 mm. The mean group migration was 1.94 mm (range, 0.03–6.19 mm) with a standard deviation of 1.45 mm. Overall, there was minimal change in the relative locations of the markers with respect to each other, as well as to the target. Conclusions We found that the SuperLock nitinol coil fiducial marker positions are stable throughout the radiation treatment, and can be used as a reliable surrogate to target, and to avoid geometric misses during gated treatments.

Radiation Recall Dermatitis With Concomitant Dabrafenib and Pazopanib Therapy.

Radiation Recall Dermatitis With Concomitant Dabrafenib and Pazopanib Therapy Radiation recall was first described in 1959 and is a tissue reaction that occurs in a previously irradiated area after administration usually of an antineoplastic or other class of agent.1 The incidence of radiation recall with targeted oncologic therapies is not well established. We report a case of radiation recall dermatitis occurring 3 days after initiation of combination therapy with dabrafenib and pazopanib.