Samenvatting
In the Netherlands, approximately 700 patients are diagnosed with a soft tissue sarcoma each year. These rare malignant tumors predominantly arise in the limbs. Treatment usually consists of surgical resection combined with radiotherapy.
The use of preoperative radiotherapy is rising. Preoperative radiotherapy significantly increases the risk for the development of a major wound complication following surgical resection.
Primarily non-resectable, or locally advanced, sarcomas can be treated with hyperthermic isolated limb perfusion. A high dose of chemotherapy is administered through the blood vessels of the affected limb. In most cases, it is possible to resect the tumor within six to eight weeks following this treatment. Following this, postoperative radiotherapy is administered in selected cases. An intensified and shortened regimen consisting of, isolated limb perfusion followed by preoperative radiotherapy and surgical resection was found to be feasible and safe. Besides, a similar oncological outcome was achieved, the wound complication risk was comparable and the overall treatment time was reduced.. In some cases, an amputation of the affected limb is still inevitable. However, the timing of the amputation was shown not to influence the prognosis of these patients.
FDG-PET scans are used commonly to measure metabolic tumor activity. Using a computer, the metabolically active area is delineated. The delineation technique used directly affects the calculated metabolic activity. One of the tested parameters for metabolic activity seems to correlate with the pathological tumor response as determined at pathological examination following the surgical resection. Patients’ prognosis is not influenced by the pathological tumor response.
The use of preoperative radiotherapy is rising. Preoperative radiotherapy significantly increases the risk for the development of a major wound complication following surgical resection.
Primarily non-resectable, or locally advanced, sarcomas can be treated with hyperthermic isolated limb perfusion. A high dose of chemotherapy is administered through the blood vessels of the affected limb. In most cases, it is possible to resect the tumor within six to eight weeks following this treatment. Following this, postoperative radiotherapy is administered in selected cases. An intensified and shortened regimen consisting of, isolated limb perfusion followed by preoperative radiotherapy and surgical resection was found to be feasible and safe. Besides, a similar oncological outcome was achieved, the wound complication risk was comparable and the overall treatment time was reduced.. In some cases, an amputation of the affected limb is still inevitable. However, the timing of the amputation was shown not to influence the prognosis of these patients.
FDG-PET scans are used commonly to measure metabolic tumor activity. Using a computer, the metabolically active area is delineated. The delineation technique used directly affects the calculated metabolic activity. One of the tested parameters for metabolic activity seems to correlate with the pathological tumor response as determined at pathological examination following the surgical resection. Patients’ prognosis is not influenced by the pathological tumor response.
| Originele taal-2 | English |
|---|---|
| Kwalificatie | Doctor of Philosophy |
| Toekennende instantie |
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| Begeleider(s)/adviseur |
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| Datum van toekenning | 8-okt.-2018 |
| Plaats van publicatie | [Groningen] |
| Uitgever | |
| Gedrukte ISBN's | 978-94-9301-432-9 |
| Elektronische ISBN's | 978-94-9301-433-6 |
| Status | Published - 2018 |