DOREMY: 36Gy preop radiotherapy (RT) in myxoid liposarcoma preserves ~97% 5-year local control with low late toxicity

Preoperative RT de-escalation to 36Gy in 18×2Gy followed by resection was tested in the prospective single-arm Phase 2 DOREMY trial in localized, translocation-confirmed myxoid liposarcoma of the trunk/extremity across 9 European/US sarcoma centers (n=90; median follow-up 66.4 months; NCT02106312). Five-year local recurrence–free survival was 97.4% (PFS 81.0%, DSS 89.5%, OS 88.5%), with 21% wound complications (16% requiring intervention) and grade 2/3 late toxicities in 15%/3%; this appears broadly comparable on local control to historical “standard” preop STS RT at 50Gy/25fx, but potentially with less cumulative RT burden than the 50Gy regimen that is widely used and associated with meaningful wound morbidity (major wound complications ~35% in a landmark randomized STS timing trial).