The SCOPES study

Background

Soft tissue sarcomas are an inhomogenous group of malignant and relatively rare tumors of connective tissue which can occur anywhere in the body and that affect adults as well as children. Treatment of soft tissue sarcomas located in extremities, their most common localization, usually consists of preoperative radiation therapy and subsequent surgery. A 25 x 2 Gy schedule over 5 weeks has been adapted as the gold standard in preoperative radiation treatment. However, while preoperative radiotherapy provides several advantages for patients, it can lead to delayed wound healing after surgery, which represents one of its main limitations. Additionally, the 5 week treatment period is perceived as quite long by patients, significantly impacting their quality of life.

Aims

The SCOPES study will put to test a hypofractionated preoperative regimen of 14 x 3 Gy over 3 weeks, which has been previously calculated as iso-toxic and iso-effective based on radiobiological parameters, compared to the standard 25 x 2 Gy over 5 weeks. The study will compare the wound healing complication rates and local control between the two schedules, as well as the treatment-related burden for patients and the cost-effectiveness of the two regimens.

Relevance for cancer research

A successfully adapted hypofractionated regimen, associated with a shorter overall treatment time and fewer hospital visits might improve the quality of life and help lighten the treatment burden for patients, as well as their caregivers and families, while also continuing to provide safe treatment with equal outcomes. At the same time, a reduction in treatment sessions with a subsequent relief in workforce and cost could also prove to have a beneficial impact on our overburdened healthcare system.

Team

• Prof. dr. M. Fiocco, Mathematical Institute Leiden University, Department of Biomedical Data Sciences Leiden University Medical Center & Princess Máxima Center for Pediatric Oncology 

• Prof. dr. R. L. M. Haas, MD, Department of Radiotherapy, Leiden University Medical Center & The Netherlands Cancer Institute

• Dr. L. M. Wiltink, MD, PhD, Department of Radiotherapy, Leiden University Medical Center

• Drs. F. Foppele, MD, Department of Radiotherapy, Leiden University Medical Center & The Netherlands Cancer Institute