S1047
Clinical – Sarcoma, skin cancer, malignant melanoma
ESTRO 2026
extremity sarcoma treated with image-guided radiation therapy to a reduced target volume: results of RTOG 0630 trial. J Clin Oncol. 2015;33:2231– 2238.Noeuveglise M et al. Preoperative versus postoperative radiotherapy for localized soft tissue sarcoma treated with curative intent in a French tertiary center “SARCLOC”. BMC Cancer. 2024;24:1550 Keywords: Sarcoma, Extremities, Postoperative radiotherapy A Systematic Review of Radiation-Induced Skin Reaction Assessment in People with Skin of Colour Naman Julka-Anderson 1,2 , Elizabeth Joyce 3 , Katie Read 3 , Emma-Jane White 3 , Jayde Nartey 3 , Samina Hussain 4 , Olivia Lond-Caulk 5 , Stewart O'Callaghan 6 , Anna M Kirby 3 , Susanne Cruickshank 1 , Sofia Georgopoulou 1 1 Applied Health Research, Royal Marsden Hospitals, London, United Kingdom. 2 Centre for Clinical Expertise, Macmillan Cancer Support, London, United Kingdom. 3 Radiotherapy, Royal Marsden Hospitals, London, United Kingdom. 4 Sakoon Through Cancer Charity, Sakoon Through Cancer Charity, London, United Kingdom. 5 The Leanne Pero Foundation, The Leanne Pero Foundation, London, United Kingdom. 6 OutPatients Charity, OutPatients Charity, London, United Kingdom Digital Poster 3795 Purpose/Objective: Radiation-induced skin reactions (RISR) are common following external beam radiotherapy, yet assessment tools rely on erythema-based descriptors that are poorly visualised in people with brown and black skin. This may lead to under-recognition of toxicity and inequities in care. A systematic literature review was performed to evaluate how RISR is assessed in people of colour, identify current limitations, and explore alternative approaches. Material/Methods: MEDLINE, EMBASE, CINAHL, BNI and clinical trials.gov) were searched (January 1990 to current) for studies reporting RISR in adults with skin of colour treated with radiotherapy. Data on patient characteristics, skin tone assessment, clinician- and patient-reported tools, Following PRISMA guidelines (PROSPERO ID CRD420251032837), six databases (PUBMED, outcomes were collected, and the quality of each study was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: From 10,104 records, 36 studies met the inclusion criteria. The included studies were prospective observational studies (n=17) qualitative and mixed methods studies (n=6), SLRs (n=5), RCTs (n=5), consensus articles (n=2) and one retrospective study.
received adjuvant chemotherapy. Postoperative RT was delivered with 3D-conformal RT (24.7%) or intensity-modulated RT (75.3%) at a median dose of 60 Gy (range, 30–70 Gy). Acute grade 2 and 3 dermatitis occurred in 14.9% and 0.9% of the patients, respectively. Late toxicities were entirely grade 1–2, including skin toxicity (13.5%), edema (29.8%), and fibrosis (44.0%), with no ≥ grade 3 events. Wound complications occurred in 12 patients (5.6%). MSTS scores showed no significant decline after surgery and postoperative RT, indicating preserved functional outcomes. At a median follow-up of 50.1 months, the 5-year LRFS, DFS, and OS rates were 88.1%, 61.4%, and 77.6%, respectively.
Conclusion: Carefully planned and precisely delivered
postoperative RT for E-STS is associated with minimal high-grade toxicity, including low-risk fibrosis and edema, and maintains patient-reported functional outcomes. These results suggest that postoperative RT can achieve effective local control without compromising quality of life, supporting its continued role as a safe treatment strategy. Comparative studies with preoperative RT cohorts are warranted to further refine optimal practice. References: O’Sullivan B et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet. 2002;359:2235–2241.Davis AM et al. Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother Oncol. 2005;75:48–53.Wang D et al. Significant reduction of late toxicities in patients with
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