Multinational phase 2 trial of long-term outcomes with reduced-dose preoperative radiotherapy in myxoid liposarcoma

The phase 2 DOREMY nonrandomized trial, at 9 tertiary sarcoma centers in Europe and the US, investigated long-term outcomes after reduced-dose preoperative radiotherapy for myxoid liposarcoma (MLS). Eligible patients were adults with biopsy-proven and translocation-confirmed localized MLS of the trunk or extremity. The patients received preoperative radiotherapy to a reduced dose of 36 Gy in once-daily 2-Gy fractions followed by resection. Ninety patients (mean age 47 ± 13.1 years; 56% male) were included and followed-up for a median of 66.4 months (IQR 48.8-87.5). All patients received preoperative radiotherapy according to protocol. Surgery was not performed in three patients due to intercurrent metastatic disease. Five-year rates of local recurrence-free survival, progression-free survival, disease-specific survival, and overall survival rates were 97.4% (95% CI 93.9-100), 81.0% (72.6-89.4), 89.5% (82.6-96.4), and 88.5% (81.2-95.8), respectively. Eighteen patients (21%) experience a wound complication, and 14 (16%) required intervention. Any grade 2 or 3 late toxic effects were seen in 13 patients (15%) and 3 patients (3%), respectively. The authors conclude that this long-term analysis of DOREMY demonstrated excellent local control and a favorable toxicity profile following reduced-dose preoperative radiotherapy in patients with MLS.