A trial of IMRT to treat bone and soft tissue sarcoma (IMRiS)
Cancer type:
Status:
Phase:
This trial looked at what the side effects of IMRT are when used to treat bone and soft tissue sarcoma. IMRT is a type of radiotherapy called intensity modulated radiotherapy.
It was open to people who had one of the following:
- soft tissue sarcoma of the arm or leg
- Ewing’s sarcoma that started in the pelvis or spine
- bone sarcoma such as an osteosarcoma or a chondrosarcoma that is high grade in the pelvis and spine
-
chordoma in the pelvis or spine
More about this trial
When you have a bone or soft tissue sarcoma you might have radiotherapy:
- before surgery to shrink the cancer before removing it
- after surgery to reduce the risk of the cancer coming back
- to treat the cancer if it can’t be removed because of its position in the body
Intensity modulated radiotherapy (IMRT) matches the radiotherapy beams to the shape of the cancer. This reduces the amount of radiotherapy to the healthy tissue surrounding the cancer. This should lead to fewer side effects.
Some hospitals already use IMRT to treat bone and soft tissue sarcoma. But it hadn’t been properly tested to show if there is a benefit from treating these cancers with IMRT.
The aims of this trial were to see if:
- IMRT reduces side effects, particularly long term effects
- people with sarcoma are able to have the best dose of radiotherapy without causing damage to surrounding tissue
Summary of results
The researchers have published the results of one part of the trial. So far, this trial has found that IMRT reduces soft tissue fibrosis in people with soft tissue sarcoma of the leg or arm. This is when compared with standard radiotherapy.
Results
The trial team looked at 3 groups of people in this trial. They were people with:
- soft tissue sarcoma of the arm or leg – Group 1
- Ewing’s sarcoma that started in the pelvis or spine – Group 2
- another bone sarcoma that started in the pelvis or spine – Group 3
These are the results of Group 1. When the results of Group 2 and Group 3 are available we will update this summary.
Group 1
In this group 159 people had IMRT:
- 106 had IMRT before surgery
- 53 had IMRT after surgery
Side effects
A side effect of radiotherapy is soft tissue 
. This is an abnormal increase of fibrous tissue at the treatment site. This can make the tissue less stretchy.
At 2 years after treatment, the team looked at how many people had moderate to severe soft tissue fibrosis. Of the 159 people who had IMRT, they were able to look at 111 people. They found that 12 out of the 111 people had moderate to severe soft tissue fibrosis. This is almost 11%. Research has shown that this is around 28% with standard radiotherapy.
The team also looked to see whether there was a difference between people who had IMRT before surgery or after surgery. They found that there was not much of a difference between them.
The team looked at how often other side effects were experienced, such as:
- skin changes (in 6.3% of people)
- bone pain and fractures (in 2.7% of people)
- joint pain and stiffness (in 8.8% of people)
- swelling of the arm or leg (in 5.3% of people)
They found that only small numbers of people had these as long term side effects. The team looked at whether there were differences between those who had IMRT before or after surgery. The only side effect where there was a difference was skin changes. It was higher for people who had IMRT after surgery.
Quality of life
The team looked at the changes in people’s quality of life 2½ years after they joined the trial. They found that over the time people’s:
- physical activity had decreased
- overall health had improved
- work, social activities and relationships with others had improved
- feelings and emotional state such as anxiety and depression had improved
They also looked at how surgery to the arm or leg affected how well these people could use their limb. They found that there was no change from when the people joined the trial to 2 and 3 years after.
How well IMRT worked
The team looked at the percentage of people who were alive 2 years after treatment was completed. They found it was 86.4% (almost 9 out of 10 people).
They also looked at the percentage of people whose sarcoma returned in the same area within 2 years of treatment. They found it was 10% (approximately 1 in 10 people).
These results are the same the team would expect if the treatment was standard radiotherapy.
Conclusion
The team concluded that soft tissue fibrosis is much lower after IMRT than standard radiotherapy. And this trial provides further evidence for the benefits of having IMRT before or after surgery for people with a soft tissue sarcoma of the arm or leg.
More detailed information
There is more information about this research in the reference below.
Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.
The IMRiS Trial: A Phase 2 Study of Intensity Modulated Radiation Therapy in Extremity Soft Tissue Sarcoma
B Seddon and others
International Journal of Radiation Oncology, Biology, Physics, 2024. Volume 120, issue 4, pages 978 to 989.
Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists () and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Dr Beatrice Seddon
Supported by
Cancer Research UK
University College London Cancer Trials Centre (UCL CTC)
The Radiotherapy Trials Quality Assurance (RTTQA) Group
Other information
This is Cancer Research UK trial number CRUK/14/015.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
