Moderately Hypofractionated, Preoperative Radiotherapy in Patients With Soft Tissue Sarcomas (Hyport-Sts): Updated Local Control, Late Toxicities, and Patient-Reported Outcomes

Authors

Andrew J Bishop
Devarati Mitra
Ahsan Farooqi
David M Swanson
Caroline Hempel
Tiara Willis
Chris Pearlnath
Wei-Lien Wang
Ravin Ratan
Neeta Somaiah
Robert S Benjamin
Keila E Torres
Kelly K Hunt
Christopher P Scally
Emily Z Keung
Robert L Satcher
Justin E Bird
Patrick P Lin
Bryan S Moon
Valerae O Lewis
Christina L Roland
B Ashleigh Guadagnolo

Language

English

Publication Date

1-1-2025

Journal

Cancer

DOI

10.1002/cncr.35542

PMID

39192597

PMCID

PMC11695168

PubMedCentral® Posted Date

1-1-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Moderately hypofractionated, preoperative radiotherapy in patients with soft tissue sarcomas (HYPORT-STS; ClinicalTrials.gov identifier NCT03819985) investigated a radiobiologically equivalent, moderately hypofractionated course of preoperative radiotherapy (RT) 15 × 2.85 Gy in patients with soft tissue sarcoma (STS). Here, the authors report longer term follow-up to update local control and report late toxicities, as well as functional and patient-reported outcomes.

Methods: HYPORT-STS was a single-center, open-label, single-arm, prospective phase 2 clinical trial that enrolled 120 eligible adult patients with localized STS of the extremities or superficial trunk between 2018 and 2021. Patients received a 3-week course of preoperative RT followed by surgery 4-8 weeks later. End points and follow-up were analyzed from the date of surgery.

Results: The median follow-up was 43 months (interquartile range, 37-52 months), and the 4-year local recurrence-free survival rate was 93%. Overall RT-related late toxicities improved with time from local therapy (p < .001), and few patients had grade ≥2 toxicities (9%; n = 8 of 88) at 2 years. These included: 2% grade ≥2 skin toxicity, 2% fibrosis, 3% lymphedema, and 1% joint stiffness. Four patients (3%) had bone fractures. Both functional outcomes, as measured by the Musculoskeletal Tumor Society Rating Scale (p < .001), and quality of life, as measured by the Functional Assessment of Cancer Therapy-General (p < .001), improved with time from treatment, and both measures were better in follow-up at 2 years compared with baseline.

Conclusions: Long-term follow up suggests that moderately hypofractionated preoperative RT for patients with STS is safe and effective. Higher grade late toxicities affect a minority of patients. Late toxicities decrease over time, whereas functional outcomes and health-related quality of life seem to improve with more time from combined modality treatment.

Keywords

Adult, Aged, Female, Humans, Male, Middle Aged, Follow-Up Studies, Patient Reported Outcome Measures, Preoperative Care, Prospective Studies, Quality of Life, Radiation Dose Hypofractionation, Sarcoma, Soft Tissue Neoplasms, sarcoma, hypofractionated, radiation, preoperative, soft tissue, hypofractionation, radiation therapy

Published Open-Access

yes

Recommended Citation

Bishop, Andrew J; Mitra, Devarati; Farooqi, Ahsan; et al., "Moderately Hypofractionated, Preoperative Radiotherapy in Patients With Soft Tissue Sarcomas (Hyport-Sts): Updated Local Control, Late Toxicities, and Patient-Reported Outcomes" (2025). Faculty, Staff and Student Publications. 5966.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5966