Radiotherapy innovation in rare diseases-focusing on the value of single institutional experiences for hypofractionated radiotherapy in soft tissue sarcoma

We note the interest by Hsu and Kao in our recent publication [ [1] Mayo Z.S. Parsai S. Asha W. et al. Early Outcomes of Ultra-Hypofractionated Preoperative Radiation Therapy for Soft Tissue Sarcoma Followed by Immediate Surgical Resection. Radiother Oncol. 2022; : 109439 PubMed Google Scholar ]. This single institutional series is a contribution to the growing literature of hypofractionated preoperative radiotherapy for soft tissue sarcoma. Similar to many early experiences, the power of this series is limited, as acknowledged in the discussion. The authors highlight the largest published series, and we applaud Kosela-Paterczyk et al. for their early adoption of hypofractionated radiotherapy and publishing a series with over 300 patients [ [2] Koseła-Paterczyk H. Teterycz P. Spałek M.J. et al. Efficacy and Safety of Hypofractionated Preoperative Radiotherapy for Primary Locally Advanced Soft Tissue Sarcomas of Limbs or Trunk Wall. Cancers (Basel). 2021; 13 Crossref PubMed Scopus (5) Google Scholar ]. However, we note that only 25% of published series include >52 patients, and the median number of patients included in series for >25 Gy in 5 fractions is 25, similar to our 22. For a series of more than 200 patients to take place in the United States, it would likely require a cooperative group trial and will be over a decade from now before end point results are available, highlighting the value of current experiences. Methodological concerns for ultra-hypofractionated neoadjuvant radiation therapy in soft tissue sarcomaRadiotherapy and OncologyVol. 183PreviewWe found the recently published study on the use of ultra-hypofractionated neoadjuvant radiation therapy followed by immediate operation for soft tissue sarcoma treatment to be informative and noteworthy [1]. However, we would like to raise some concerns. Full-Text PDF