The effectiveness of the use of local hyperthermia as a method of physical radiosensitization as part of the combined treatment of localized forms of primary and recurrent sarcomas of soft tissues

Objective. To estimate the effectiveness and tolerance of soft tissue sarcoma (STS) combined treatment, including preoperative thermoradiotherapy (TRT), surgical treatment and intraoperative radiation therapy (IORT).

Methods. We assessed the tolerance and both immediate and long-term results of treatment for 105 patients with locally advanced STS, 50 of whom underwent combined treatment with local hyperthermia (LHT) (prospective set). 55 patients from the control group received treatment without the use of LHT (retrospective group).

Results. It was proven that the preoperative course of TRT significantly increases the frequency of objective clinical response in the study group — 30% versus 9.1% in the control (p<0.05). The prevalence of two-year relapse-free and overall survival was observed in patients of the study group with recurrent STS — 77.8% compared with the control group — 46.7% (p=0.05) and 100% versus 86.7%, respectively (p=0.05). The incidence of early radiation reactions and late radiation changes is comparable in both groups.

Conclusion. The use of TPT contributes to a significant increase in the frequency of an objective clinical response, and allows to improve two-year relapse-free and overall survival in a subgroup of patients with relapses of SMT. When prescribing the TRT course, it is necessary to take into account the main clinical and morphological factors that have a significant impact on its immediate effectiveness. LHT as a radiosensitizer in the combined treatment of SMT does not adversely affect the frequency and degree of radiation reactions/changes in normal tissues.