Professor Wang Binliang: Radiotherapy is in the ascendant in soft tissue sarcoma with broad prospects

Foreword It is well known that radiotherapy has an important position in the adjuvant therapy and neoadjuvant therapy of soft tissue sarcoma
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In recent years, with the continuous advancement of radiotherapy technology, its clinical applications have become more extensive
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At present, radiotherapy combined with systemic therapy, such as chemotherapy, targeted drugs, immunotherapy, and many other studies are also being explored.
The development of these studies will help provide patients with more treatment options
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In addition, the Multidisciplinary Diagnosis and Treatment (MDT) model is an indispensable concept in cancer treatment in recent years.
It brings more power to doctors who "do it alone" and helps patients benefit more
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At the 2021 Fudan Soft Tissue Sarcoma Summit Forum held recently, Yimaitong had the honor to interview Professor Wang Binliang from Zhongshan Hospital Affiliated to Fudan University to share with us the current status and future prospects of soft tissue sarcoma treatment
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Expert Profile Professor Wang Binliang, Deputy Chief Physician, Director of Intestinal Cancer Subspecialty, Department of Radiotherapy, Zhongshan Hospital Affiliated to Fudan University, Member of the Shanghai Skin and Soft Tissue Tumor Professional Committee and Lymphoma Professional Committee, China Cancer Prevention and Treatment Union, China Anti-Cancer Association Sarcoma Professional Committee, Multidisciplinary Tumor Diagnosis and Treatment ( MDT) Academic Group Member Peking University Cancer Hospital Distinguished Advisor "Liver Cancer E-Journal" Communications Editorial Board Specializing in the radiation of breast cancer, rectal cancer, liver cancer, pancreatic cancer, bone and soft tissue tumors, retroperitoneal tumors, head and neck tumors and benign diseases Treatment of Yimaitong: In the clinical practice of soft tissue sarcoma, how do you usually choose the perioperative treatment plan? What do you think of the status of radiotherapy in the perioperative period of soft tissue sarcoma? Professor Wang Binliang: Perioperative treatment is a whole process surrounding the operation, including neoadjuvant before operation, intraoperative and postoperative adjuvant treatment
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For some patients with early stage, fewer complications or easy removal of tumors, surgery can generally be chosen
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However, for sarcomas that are difficult to remove and whose pathological grade is in the middle and high grades, adjuvant therapy or neoadjuvant therapy is generally chosen, including systemic drug therapy and radiotherapy, both of which have an important position
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So, how to choose a perioperative treatment plan? Generally, experienced medical centers and MDT teams will design individual treatment plans according to the patient's situation, and decide whether to choose drug therapy or radiotherapy, or a combination of the two, so as to give the patient the best treatment plan
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From the perspective of radiotherapy, for extremities or abdominal soft tissue sarcomas, we prefer preoperative radiotherapy, because the radiation dose is low, the range is small, there are fewer late complications, and the patients benefit more
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For some patients with special abdominal soft tissue sarcoma, postoperative radiotherapy is usually selected.
During the operation, a patch may be used to isolate the gastrointestinal tract, and then postoperative radiotherapy is performed
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All in all, the choice of perioperative treatment options for soft tissue sarcoma is very complicated and requires a comprehensive discussion by the team
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Yimaitong: What are your expectations for the prospects of adjuvant and neoadjuvant therapy for soft tissue sarcoma? Professor Wang Binliang: At present, adjuvant and neoadjuvant therapies are developing rapidly in soft tissue sarcoma and are in the ascendant
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However, soft tissue sarcoma is a niche type of tumor, and there may be some controversies or insufficient evidence-based medical evidence in its treatment options, so further exploration is needed
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From the perspective of radiotherapists, radiotherapy technology has been continuously improved in auxiliary and neoadjuvant treatments, from the initial two-dimensional radiotherapy to three-dimensional conformal radiotherapy, and then to more advanced intensity-modulated conformal radiotherapy
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At present, the radiotherapy technology in Zhongshan Hospital of Fudan University is also constantly innovating.
Today, TOMO Therapy is often used, that is, spiral tomography radiotherapy
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In the choice of radiation, we have also adopted better radiation, such as protons/heavy ions, which may have greater significance for inert soft tissue sarcoma
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From another perspective, radiotherapy can also be combined with other treatment methods, including traditional chemotherapy, or new targeted drugs and immunotherapy.
At present, these studies are still under continuous exploration, and we hope to achieve better Result
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Recommended reading: Professor Wang Jian: Taking the benefit of patients as the original intention and consensus as the navigation mark to drive the development of bone and soft tissue sarcoma in China to conquer sarcoma and start a new journey | 2021 Fudan Soft Tissue Sarcoma Summit Forum successfully concluded to build an oasis and conquer sarcoma | 2021 Fudan Soft Tissue Sarcoma Summit Forum Grand Opening Forum Frontier｜"Immunotherapy-From Dawn to Sunrise" Sub-forum Review of Wonderful Topics