656357eb62f584749f635eee595a5aca 334585.pdf 5dd46ec1d659723b24752ede022b33cc99e61a34 334585.pdf 6054ba74159a41ceb5cdead402d6cc0aba9a131a8a217d3bcb16c76491fb08aa 334585.pdf Title: Role of Spatially Fractionated Radiotherapy (LATTICE) Treatment in Inoperable Bulky Soft-Tissue Sarcomas Subject: Background: The clinical outcome of inoperable sarcoma patients treated with LATTICE (LRT) is limited and therefore the objective of our study was to report treatment response, overall survival (OS), local-recurrence free survival (LRFS) and toxicity. Methods: This retrospective observational study includes 15 histologically proven inoperable non-extremity sarcoma patients with no treatment options or no response to systemic therapy, treated at our institution between 2020 and 2024. The patients were treated with a combination of LRT and normo- or hypo-fractionated external beam radiotherapy. Treatment response was evaluated by RECIST1.1 criteria, toxicity by CTCAE 5.0 and OS and LRFS by Kaplan–Meier curves. Results: The median follow-up (F-UP) since the beginning of the treatment was 10 months (range 4–32). Nine patients were male and six female. Their mean age was 60 years. The median gross tumor volume (GTV) was 1058 cm3 (range 142–6103 cm3). The median number of spheres was 9 (4–30). All patients with symptoms reported symptoms’ relief. Based on RECIST1.1 criteria, 10 patients (67%) had stable local disease at 1–2 months F-UP on computed tomography (CT). Surgical resection was feasible in five patients. Three of them are alive without disease and two died due to metastatic progression. From 10 (67%) non operated patients, 5 patients died (50%) due to disease. The remaining five patients (50%) are alive, three with stable disease at 21, 22, and 32 months of F-UP and two with disease progression who are currently receiving palliative chemotherapy treatment. Reported G2 toxicity was as follows: gastrointestinal (2), asthenia (1). Two patients had G3 toxicity: esophagitis (1) and inguinal dermatitis (1). No acute or chronic G4–G5 toxicity was observed. Conclusions: LRT is a feasible and well-tolerated radiation technique for inoperable bulky soft-tissue sarcomas. Further studies are needed to establish protocols to determine which patients could benefit from palliative or preoperative treatment. Keywords: sarcoma; SFRT; LATTICE LRT; GRID Author: Katarina Majercakova, Natalia Tejedor Aguilar, Josep Isern Verdum, Helena Vivancos Bargalló, Antonio Vila Capel, Miriam Mancera Soto, Guillermo Gómez de Segura Melcón, Jady Vivian Rojas Cordero, José Antonio González-López, Silvia Bagué Rosell, Diana Hernandez Jover, Saba Rabi Mitre, Ana Peiró Ibañez, Ana Sebio and Gemma Sancho-Pardo Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Feb 13 05:20:09 2025 CET ModDate: Thu Feb 13 05:24:15 2025 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1477829 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ESVHPV+URWPalladioL-Roma Type 1 Custom yes yes yes 10 0 VYLDXW+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 FJLKAZ+URWPalladioL-Ital Type 1 Custom yes yes yes 21 0 KOSUXD+CMSY10 Type 1 Builtin yes yes yes 47 0 PDIGDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 65 0 PDIGDL+PalatinoLinotype CID TrueType Identity-H yes yes yes 68 0 PDIGDM+PalatinoLinotype TrueType WinAnsi yes yes no 74 0 PDIGDO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 77 0 PDIGLM+PalatinoLinotype TrueType MacRoman yes yes no 80 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 88 0 PDIGDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 106 0 PDIGDL+PalatinoLinotype CID TrueType Identity-H yes yes yes 109 0 PDIGDM+PalatinoLinotype TrueType WinAnsi yes yes no 115 0 PDIGDO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 118 0 PDIGLM+PalatinoLinotype TrueType MacRoman yes yes no 121 0 PDIGDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 134 0 PDIGDL+PalatinoLinotype CID TrueType Identity-H yes yes yes 137 0 PDIGDM+PalatinoLinotype TrueType WinAnsi yes yes no 143 0 PDIGDO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 146 0 PDIGLM+PalatinoLinotype TrueType MacRoman yes yes no 149 0 HQBQWV+VnURWPalladioL Type 1 Custom yes yes yes 164 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-07-31 04:28:21 CEST RepresentationInformation: 334585.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-07-30 12:38:15 CEST Size: 1477829 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 325 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Treatment Planification Destination: subsection.2.1 Item: Title: Clinical Evaluation Destination: subsection.2.2 Item: Title: Results Destination: section.3 Children: Item: Title: Patients’ Characteristics Destination: subsection.3.1 Item: Title: Treatment Characteristics Destination: subsection.3.2 Item: Title: Treatment Outcome Destination: subsection.3.3 Item: Title: Toxicity Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Role of Spatially Fractionated Radiotherapy (LATTICE) Treatment in Inoperable Bulky Soft-Tissue Sarcomas Author: Katarina Majercakova, Natalia Tejedor Aguilar, Josep Isern Verdum, Helena Vivancos Bargalló, Antonio Vila Capel, Miriam Mancera Soto, Guillermo Gómez de Segura Melcón, Jady Vivian Rojas Cordero, José Antonio González-López, Silvia Bagué Rosell, Diana Hernandez Jover, Saba Rabi Mitre, Ana Peiró Ibañez, Ana Sebio and Gemma Sancho-Pardo Subject: Background: The clinical outcome of inoperable sarcoma patients treated with LATTICE (LRT) is limited and therefore the objective of our study was to report treatment response, overall survival (OS), local-recurrence free survival (LRFS) and toxicity. Methods: This retrospective observational study includes 15 histologically proven inoperable non-extremity sarcoma patients with no treatment options or no response to systemic therapy, treated at our institution between 2020 and 2024. The patients were treated with a combination of LRT and normo- or hypo-fractionated external beam radiotherapy. Treatment response was evaluated by RECIST1.1 criteria, toxicity by CTCAE 5.0 and OS and LRFS by Kaplan Meier curves. Results: The median follow-up (F-UP) since the beginning of the treatment was 10 months (range 4 32). Nine patients were male and six female. Their mean age was 60 years. The median gross tumor volume (GTV) was 1058 cm3 (range 142 6103 cm3). The median number of spheres was 9 (4 30). All patients with symptoms reported symptoms’ relief. Based on RECIST1.1 criteria, 10 patients (67%) had stable local disease at 1 2 months F-UP on computed tomography (CT). Surgical resection was feasible in five patients. Three of them are alive without disease and two died due to metastatic progression. From 10 (67%) non operated patients, 5 patients died (50%) due to disease. The remaining five patients (50%) are alive, three with stable disease at 21, 22, and 32 months of F-UP and two with disease progression who are currently receiving palliative chemotherapy treatment. Reported G2 toxicity was as follows: gastrointestinal (2), asthenia (1). Two patients had G3 toxicity: esophagitis (1) and inguinal dermatitis (1). No acute or chronic G4 G5 toxicity was observed. Conclusions: LRT is a feasible and well-tolerated radiation technique for inoperable bulky soft-tissue sarcomas. Further studies are needed to establish protocols to determine which patients could benefit from palliative or preoperative treatment. 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