TOPLINE:

In a retrospective analysis, moderately hypofractionated definitive radiotherapy (MHDRT) achieved 1-year local control rates of more than 90% for soft tissue sarcomas (STS) and 100% for chordomas in non-extremity locations with acceptable toxicity.

METHODOLOGY:

• Researchers retrospectively analysed 59 adult patients with sarcoma (median age, 60 years), including 37 patients with STS and 23 with bone sarcomas (14 chordomas and nine high-grade bone tumours), who received MHDRT between July 2021 and September 2024.
• Radiotherapy was delivered at two dose levels: 50.4 Gy in 28 fractions to patients with a low-dose planning target volume and a simultaneous integrated boost of 63 Gy (for STS) and 70 Gy (for bone sarcomas) to those with a high-dose planning target volume in 28 fractions.
• Clinical outcomes included local control, progression-free survival, metastasis-free survival, overall survival, and acute and late toxicities.

TAKEAWAY:

• Overall, at a median follow-up of 17.7 months, local control was maintained in 80% of patients, with 1-year rates of 90.8% for STS, 100% for chordomas, and 55.6% for high-grade bone sarcomas.
• Progression-free survival and overall survival at 1 year varied significantly: 59.9% and 94.4% for STS, 85.7% and 92.3% for chordomas, and 27.8% and 47.4% for high-grade bone tumours, respectively.
• Among patients without metastasis at baseline, 1-year metastasis-free survival was 71.5% for STS and 91.7% for chordomas.
• Treatment toxicity remained manageable, with acute clinical toxicities of grade 3 occurring in 8.3% of patients, and 10% of patients experienced adverse events of grade 3 in the late phase.

IN PRACTICE:

"In conclusion, MHDRT was feasible to deliver dosimetrically with acceptable acute and late toxicity, produced tangible patient benefits in terms of preserved function and improved symptom control, and resulted in promising early rates of local tumour control," the authors wrote. "A prospective clinical trial with long-term follow-up could verify these results but would be challenging to deliver, requiring collaboration at the national or international level to achieve adequate patient numbers," they added.

SOURCE:

This study was led by Jonathan D. Towler, The London Sarcoma Service, University College Hospital, London, England. It was published online on December 09, 2025, in Clinical Oncology.

LIMITATIONS:

This study was limited by the short duration of follow-up, and the small number of patients, particularly in chordoma and high-grade bone tumour cohorts, reflected the rarity of these tumours even in a high-volume centre. Toxicity data for this study might have been captured less comprehensively than those for a prospective trial. Additionally, it was not possible to formally assess the impact of treatment on quality of life and functional status without contemporaneous patient-reported outcomes.

DISCLOSURES:

No funding information was provided for the study. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.