title: Feasibility report of conservative surgery, perioperative high-dose-rate brachytherapy (PHDRB), and low-to-moderate dose external beam radiation therapy (EBRT) in pediatric sarcomas.
abstract: OBJECTIVE
  This study was undertaken to determine the feasibility of perioperative high-dose-rate brachytherapy (PHDRB) as an accelerated boost in patients with pediatric sarcomas.
  
  
  METHODS
  Five pediatric patients (ages 7-16) with soft tissue sarcomas (STS) or soft tissue recurrences of previously treated osteosarcomas were treated with surgical resection and PHDRB (16-24 Gy) for R0-R1 resections. Patients with STS and osteosarcomas received 27 Gy and 45 Gy of EBRT postoperatively.
  
  
  RESULTS
  After a median follow-up of 27 months (range, 12-50) all the patients remain locally controlled. Only 1 patient developed regrowth of pulmonary metastases and died of distant disease at 16 months.
  
  
  CONCLUSIONS
  The use of PHDRB is safe in the short-term in this pediatric population. Only 1 patient suffered a partial wound dehiscence that may not be entirely related to PHDRB. Patients with recurrent osteosarcomas can be treated in a fashion similar to their adult soft tissue counterparts and avoid limb amputation. Younger patients with STS may achieve local control and prevent growth retardation with a combination of PHDRB and moderate doses of EBRT.
authors.affiliation: Department of Oncology, University Clinic, University of Navarra, Avda Pío XII s/n, Pamplona, E-31080 Navarre, Spain. rmartinezm@unav.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez-Monge
authors.forename: Cristina
authors.initials: C
authors.lastname: Garrán
authors.forename: Mauricio
authors.initials: M
authors.lastname: Cambeiro
authors.forename: Mikel
authors.initials: M
authors.lastname: San Julián
authors.forename: Juan
authors.initials: J
authors.lastname: Alcalde
authors.forename: Luis
authors.initials: L
authors.lastname: Sierrasesúmaga
mesh_terms: D000293:Adolescent; D001918:Brachytherapy / Q000379:methods*; D002648:Child; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D017809:Fatal Outcome; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019990:Perioperative Care / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D011882:Radiotherapy, High-Energy; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome