What question did this study set out to answer?

The study aims to evaluate the outcomes and pathological responses of reduced-dose preoperative radiotherapy in patients with myxoid liposarcoma.

March 12, 2026Open Access

84MO Phase I study of the tetravalent death receptor 5 (DR5) agonist ozekibart (INBRX-109) combined with irinotecan (I) and temozolomide (T) in adolescents and adults with Ewing sarcoma

RCRashmi ChughRoche (Switzerland)BWBreelyn A. WilkyUniversity of Colorado Cancer Center OAO. AleseEmory University

Key Points

The study aims to evaluate the outcomes and pathological responses of reduced-dose preoperative radiotherapy in patients with myxoid liposarcoma.
Pooled data analysis from two Phase II trials (36 Gy/18 fractions and 25 Gy/5 fractions)
87 patients received preoperative radiotherapy followed by limb-sparing surgery
Histopathological evaluation of resected specimens for changes such as hyalinization and necrosis
Outcomes assessed included R0 resection rate, local control, distant metastasis-free survival (DMFS), and overall survival (OS)
R0 resection achieved in 94.3% of patients with 100% local control
4-year DMFS was 82.8%, and 4-year OS was 90.1% with no significant difference between treatment regimens
Higher hyalinization observed in the 36 Gy regimen compared to 25 Gy (median 50% vs 25%, p=0.003)
Histopathologic response parameters mostly reflected stromal changes instead of necrosis

Abstract

Background: Myxoid liposarcoma (MLPS) is a highly radiosensitive (RT) sarcoma subtype.The aim of our study is to analyze pooled data from two phase II trials (DOREMY: 36 Gy/18 fractions; LIPOMYX: 25 Gy/5 fractions) to evaluate pathological response and outcomes of reduced-dose preoperative RT.Methods: 87 patients with primary MLPS received preoperative RT (36 Gy or 25 Gy) followed by limb-sparing surgery.Histopathological changes (hyalinization, fatty maturation, necrosis) were evaluated on resected specimens.Outcomes included R0 resection rate, local control, distant metastasis-free survival (DMFS), and overall survival (OS).Results: R0 resection was achieved in 94.3% with 100% local control.Nine patients (10%) developed distant metastases.The 4-year DMFS was 82.8% and the 4-year OS was 90.1%, with no significant difference between the 36 Gy and 25 Gy regimens (DMFS, p=0.27).Wound complication rates were similar (p=0.5).Pathologic analysis showed mean hyalinization 48%, fatty maturation 25%, necrosis 9.5%, and residual viable tumor 17%, with combined hyalinization+fatty maturation in 73% of cases.The 36 Gy regimen induced greater hyalinization (median 50% vs 25%, p=0.003) and combined hyalinization + fatty maturation (p=0.02),whereas 25 Gy led to higher necrosis (median 5% vs 0%, p=0.04).Histopathologic response parameters did not correlate with DMFS, except that higher necrosis showed a borderline association with worse DMFS (p=0.0502).Conclusions: Both reduced-dose regimens achieved excellent local control and high resection quality in MLPS.The histologic response was dominated by stromal changes rather than necrosis.These findings support the use of shorter, lower-dose preoperative radiotherapy as an effective approach in this radiosensitive sarcoma subtype.

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Cite This Study

Chugh et al. (Sun,) studied this question.

synapsesocial.com/papers/69b2580996eeacc4fcec74e4 https://doi.org/https://doi.org/10.1016/j.esmorc.2026.100290

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