Would you offer dose reduction to 36 Gy pre-op to a lower extremity low grade myxoid liposarcoma based on results of the DOREMY non-randomized data?

This is a great question. In consultation, I start discussing standard preoperative RT over 5 weeks, but then review the nuances of myxoid liposarcomas (e.g., radiosensitivity). We had a thoughtful discussion about the DOREMY study, including the de-intensification radiotherapy approach, results, and some limitations. I provide my opinion that this is likely going to result in the same low risk of local recurrence as standard fractionation, but we don't have long-term data to say that for sure. I discuss the pros and cons of each dose/fractionation scheme and have patients involved in the decision process. Most have opted for 36 Gy at 2 Gy/fx.

As a side note, the authors have encouraged the international sarcoma community to participate in a...