Currently, soft tissue sarcomas (STS) are preoperatively irradiated in a conventionally fractionated regimen of 25 x 2 Gy in five weeks. Recent radiobiological investigations, however, have revealed a rationale for sensitivity to (modest) hypofractionation. The so called “SCOPES” study (Short Course Of Preoperative radiotherapy in Extremity Sarcomas) will investigate, in a prospective randomized trial, a new and patient friendly preoperative regimen of 14 x 3 Gy in the hypothesis that both the postoperative wound complication rate as well as the local control probability at two years are comparable to the current clinical practice of 25 x 2 Gy. It is expected that patients will experience less treatment related burden (a better quality of life) due to the shorter radiotherapy regimen. Apart from the oncological endpoints, quality of life and cost-effectiveness will therefore be studied.
This trial is the first randomized clinical trial ever performed in the preoperative setting of sarcoma patients. Twenty years ago the Canadian sarcoma group randomized 33 radiotherapy fractions after surgery to 25 fractions before operation. The SCOPES trial will randomize 25 fractions to 14 fractions both before surgery.
The Dutch Cancer Society has decided to fully sponsor this study (Grant 13697). The trial was designed and initiated by Prof. Dr. R.L.M. Haas from the Netherlands Cancer Institute in Amsterdam and the Leiden University Medical Center. The trial development was supported by SPAEN. Please find more information on the trial here.