[Methodology, technical prerequisites and postoperative morbidity of intraoperative radiotherapy (IORT) of soft tissue sarcomas. Heidelberg Krankengut 6/91-9/92].
Since June 1991 the IORT facility has operated a dedicated linear accelerator, which was installed within the central operating theater of the Department of Surgery. As of 9/92 a total of 28 patients suffering from peripheral (n = 20) or centrally (n = 8) located soft tissue sarcomas had been were treated. Thirteen patients revealed a primary and 15 patients a recurrent tumor. Tumor resection with negative margins was performed in 20 patients, positive margins remained in 5 patients, and gross macroscopic residual disease in 3 patients. Combined intraoperative and external beam radiotherapy was applied in 22 patients, using IORT doses of 10-20 Gy and an external beam dose of 26-50 Gy. Three patients were irradiated intraoperatively twice with a time interval of 24 h. After a median follow-up of 9.9 months, 20 patients are disease free. Two patients died 4 and 5 months after the end of therapy with rapidly progressive distant metastases. An infield failure within the external beam target volume was seen in 1 patient and local failure at the field margin of the external field in 3 patients. So far, there have been no IORT infield failures. Follow-up is performed with magnetic resonance imaging. In 3 patients a second operation was necessary because of a severe wound infection, including one patient suffering from osteomyelitis of a neighboring bone. Mild sensory neuropathy occurred in 1 patient 7 months after treatment. Overall only mild and reversible postoperative and posttherapeutic complications were seen.(ABSTRACT TRUNCATED AT 250 WORDS)
Eble
M J
MJ
Abteilung Klinische Radiologie, Radiologische Universitätsklinik, Heidelberg.
Quentmeier
A
A
Ewerbeck
V
V
Herfarth
C
C
Wannenmacher
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D018219:Histiocytoma, Benign Fibrous / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008080:Liposarcoma / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009873:Operating Rooms; D010315:Particle Accelerators; D011882:Radiotherapy, High-Energy; D012509:Sarcoma / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery*; D013584:Sarcoma, Synovial / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery
Methodik, technische Voraussetzungen und postoperative Morbidität der intraoperativen Radiotherapie (IORT) bei Weichteilsarkomen. Heidelberger Krankengut 6/91-9/92.