{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T17:36:18Z","timestamp":1761154578783},"reference-count":0,"publisher":"Wiley","issue":"3-4","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Sarcoma"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:p><jats:italic>Purpose:<\/jats:italic> Radiation therapy for retroperitoneal sarcoma remains challenging because of proximity to surrounding organs at\nrisk (OAR). We report the use of intensity modulated radiation therapy (IMRT) in the treatment of retroperitoneal sarcomas\nto minimize dose to OAR while concurrently optimizing tumor dose coverage.<\/jats:p><jats:p><jats:italic>Patients and methods:<\/jats:italic> From January 2000 to October 2002, 10 patients (average age 56 years) with retroperitoneal sarcoma\nand one with inguinal sarcoma were treated with radiation at Emory University. Prescription dose to the planning treatment\nvolume (PTV) was commonly 50.4 at 1.8 Gy\/fraction. CT simulation was used in each patient, three patients were treated\nwith 3D\u2010conformal treatment (3D\u2010CRT), and the remaining eight received multi\u2010leaf collimator\u2010based (MLC) IMRT.\nIMRT treatment fields ranged from eight to 11 and average volume treated was 3498 cc. Optimal 3D\u2010CRT plans were\ngenerated and compared with IMRT with respect to tumor coverage and OAR dose toxicity. Dose volume histograms were\ncompared for both the 3D\u2010CRT and IMRT plans.<\/jats:p><jats:p><jats:italic>Results:<\/jats:italic> Mean dose to small bowel decreased from 36 Gy with 3D\u2010CRT to 27 Gy using IMRT, and tumor coverage (V95)\nincreased from 95.3% with 3D\u2010CRT to 98.6% using IMRT. Maximum and minimum doses delivered to the PTV were\nsignificantly increased by 6 and 22%, respectively (<jats:italic>P<\/jats:italic> = 0.011, <jats:italic>P<\/jats:italic> = 0.055). Volume of small bowel receiving &gt; 30Gy was\nsignificantly decreased from 63.5 to 43.1% with IMRT compared with conventional treatment (<jats:italic>P<\/jats:italic> = 0.043). Seven patients\ndeveloped grade 2 nausea, three developed grade 2 diarrhea, one had grade 2 skin toxicity, and one patient developed grade\n3 liver toxicity (RTOG toxicity scale). No other delayed toxicities related to radiation were observed. At a median follow\u2010up\nof 58 weeks, there were no local recurrences and only one patient developed disease progression with distant metastasis in\nthe liver.<\/jats:p><jats:p><jats:italic>Conclusions:<\/jats:italic> IMRT for retroperitoneal sarcoma allowed enhanced tumor coverage and better sparing of dose to\n<jats:italic>critical normal structures<\/jats:italic> such as small bowel, liver, and kidney.\nEscalation of dose has a positive impact on local control for retroperitoneal sarcoma;\nIMRT may be an effective method to achieve this goal. We are evaluating preoperative dose escalation to 59.4 Gy.<\/jats:p>","DOI":"10.1080\/13577140310001644751","type":"journal-article","created":{"date-parts":[[2003,12,30]],"date-time":"2003-12-30T17:15:02Z","timestamp":1072804502000},"page":"137-148","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Intensity Modulated Radiation Therapy for Retroperitoneal Sarcoma:A Case for Dose Escalation and Organ at Risk Toxicity Reduction"],"prefix":"10.1155","volume":"7","author":[{"given":"Mary","family":"Koshy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome C.","family":"Landry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua D.","family":"Lawson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles A.","family":"Staley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natia","family":"Esiashvili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Howell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahram","family":"Ghavidel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence W.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,1]]},"container-title":["Sarcoma"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/sarcoma\/2003\/214218.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1080\/13577140310001644751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T23:37:31Z","timestamp":1723073851000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1080\/13577140310001644751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,1]]},"references-count":0,"journal-issue":{"issue":"3-4","published-print":{"date-parts":[[2003,1]]}},"alternative-id":["10.1080\/13577140310001644751"],"URL":"https:\/\/doi.org\/10.1080\/13577140310001644751","archive":["Portico"],"relation":{},"ISSN":["1357-714X","1369-1643"],"issn-type":[{"type":"print","value":"1357-714X"},{"type":"electronic","value":"1369-1643"}],"subject":[],"published":{"date-parts":[[2003,1]]},"assertion":[{"value":"2003-01-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}