Pulsed dose-rate perioperative interstitial brachytherapy for soft tissue sarcomas of the extremities and skeletal muscles of the trunk.
BACKGROUND
This study evaluated the role of pulsed dose-rate (PDR) brachytherapy (BRT), delivered alone or as a boost to external beam radiotherapy, as adjuvant therapy for the local control of soft tissue sarcomas of the extremities and skeletal muscles of the trunk that have undergone surgical treatment.


METHODS
Between July 1998 and January 2002, 42 patients were treated with a combination of surgery and BRT alone (18 patients) or BRT/external beam radiotherapy (24 patients) for the treatment of primary (n = 32) and recurrent (n = 10) soft tissue sarcomas located in the proximal extremity (n = 17), distal extremity (n = 17), and trunk (n = 8). Tumor size was <5 cm in 20 cases and >5 cm in 22 cases, with histological grading of 1 (n = 7), 2 (n = 18), or 3 (n = 17). The median BRT dose delivered was 15 Gy, and the median external beam irradiation dose was 50 Gy.


RESULTS
With a median follow-up of 34 months, the 36-month survival was 83.9% (SE, 6.1%), and the local control was 89%.


CONCLUSIONS
PDR interstitial BRT for soft tissue sarcoma is an effective, well-tolerated adjuvant radiation treatment that offers several practical advantages, among which are low acute and late toxicity with maximum normal tissue and critical structure sparing and overall shorter radiotherapy and hospital stay.
Lazzaro
Gianluca
G
Melonoma Unit, European Institute of Oncology, University of Milan, Via Ripamonti 435, 20141 Milan, Italy,
Lazzari
Roberta
R
Pelosi
Giuseppe
G
De Pas
Tommaso
T
Mariani
Luigi
L
Mazzarol
Giovanni
G
Sances
Daniele
D
Tosti
Giulio
G
Baldini
Federica
F
Mosconi
Massimo
M
Tedeschi
Ines
I
Viale
Giuseppe
G
Marsiglia
Hugo
H
Chiappa
Antonio
A
Vavassori
Andrea
A
Orecchia
Roberto
R
Testori
Alessandro
A
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000706:statistics & numerical data; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D015996:Survival Rate