Recurrent primary fibrosarcoma of the brain treated with the GliaSite brachytherapy system: case report.
BACKGROUND
Primary brain sarcomas are rarely curable with surgery and standard radiation therapy. They typically recur locally within 6 months of treatment. This case report describes a novel treatment approach for primary or recurrent brain sarcomas with intracavitary brachytherapy.


METHODS
This 34-year-old female presented with a large and rapidly recurrent primary fibrosarcoma in the right fronto-parietal brain only 1 month postinitial total resection. She was reoperated, again with an MRI-documented gross total resection, but at this second surgery a GliaSite RTS (a recently FDA-approved balloon catheter system for intracranial intracavitary brachytherapy) was inserted into the surgical cavity. Over four days a radiation dose of 152 Gy was delivered at the balloon surface dose and 50.0Gy was delivered at a depth of 7 mm from balloon surface. The patient received subsequent treatment with external beam radiation and chemotherapy. The patient tolerated her treatment well and has shown no evidence of tumor recurrence with a follow up of 18 months.


CONCLUSIONS
Boost intracavitary brachytherapy can play a critical role in preventing local recurrence and early death in patients with primary brain sarcomas.
Fraser
Robert W
RW
Department of Radiation Oncology, Carolinas Medical Center, Charlotte, North Carolina 28204, USA.
Limentani
Steven A
SA
Dollar
James D
JD
Asher
Anthony
A
D000328:Adult; D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D005354:Fibrosarcoma / Q000532:radiotherapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*