{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:13:41Z","timestamp":1792800821089,"version":"4.5.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of inoperable bulky soft tissue sarcomas mostly in geriatric patients presents a significant clinical challenge due to high and hypoxia-induced radioresistance, proximity to dose-limiting Organs at Risk (OARs), and the need to minimize systemic toxicity. Spatially Fractionated Radiation Therapy (SFRT), specifically 3D Lattice Radiation Therapy (LRT), offers a novel approach to safely escalate dose within the tumor volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>85-year-old female presenting a massive (20.7 x 9.8\u00a0cm), inoperable high-grade pleomorphic liposarcoma (FNCLCC Grade 3) of the right thigh. A hybrid fractionation approach was employed, consisting of conventional Volumetric Modulated Arc Therapy (VMAT) (40 Gy in 20 fractions) to the Clinical Target Volume (CTV), concurrently integrated with a weekly Lattice boost of 10 Gy, for 3 times, targeting 4 specific series of spatial vertices (Sup1, Sup2, Inf1, Inf2) using a strip-field technique. Remarkably, physical examination during the fourth week revealed a dramatic reduction in tumor consistency and pain relief.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The tailored hybrid treatment was exceptionally well tolerated with no severe acute skin toxicity. The 4-month follow-up MRI showed stable external dimensions with internal coagulative necrosis, allowing adjuvant surgery. This case highlights the feasibility, safety, and tolerability of a response-adapted weekly hybrid LRT approach for bulky extremity sarcomas especially in frail populations. We also provide a brief review of the emerging literature on SFRT\/LRT in bulky sarcomas and frail patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1932340","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:23:03Z","timestamp":1788412983000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Lattice SFRT in a geriatric patient with an initially inoperable leg bulky sarcoma: case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Francesco","family":"Di Siervi","sequence":"first","affiliation":[{"name":"Radiation Oncology Unit, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d","place":["Salerno, Italy"]},{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Curcio","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Cuocolo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno","place":["Baronissi, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Maffei","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Mainardi","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, University Hospital 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