title: High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience.
abstract: OBJECTIVE
  To report our experience treating soft tissue sarcoma (STS) with high dose rate brachytherapy alone (HBRT) or in combination with external beam radiotherapy (EBRT) in pediatric patients.
  
  
  METHODS
  Eighteen patients, median age 11 years (range 2 - 16 years) with grade 2-3 STS were treated with HBRT using Ir-192 in a interstitial (n = 14) or intracavitary implant (n = 4). Eight patients were treated with HBRT alone; the remaining 10 were treated with a combination of HBRT and EBRT.
  
  
  RESULTS
  After a median follow-up of 79.5 months (range 12 - 159), 14 patients were alive and without evidence of disease (5-year overall survival rate 84.5%). There were no local or regional failures in the group treated with HBRT alone. One patient developed distant metastases at 14 months and expired after 17 months. In the combined HBRT and EBRT group, there was 1 local failure (22 months), and 3 patients developed pulmonary metastatic disease 18, 38 and 48 months after diagnosis and no these patients were alive at the time of this report. The overall local control to HBRT alone and HBRT plus EBRT were 100 and 90%, respectively. The acute affects most common were local erythema and wound dehiscence in 6 (33%) and 4 (22%) patients. Late effects were observed in 3 patients (16.5%).
  
  
  CONCLUSIONS
  Excellent local control with tolerable side effects have been observed in a small group of paediatric patients with STS treated by HBRT alone or in combination with EBRT.
authors.affiliation: Radiation Oncology Department, Hospital do Cancer A,C, Camargo, Sao Paulo, Brazil. gusviani@gmail.com
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Viani
authors.forename: Paulo E
authors.initials: PE
authors.lastname: Novaes
authors.forename: Alexandre A
authors.initials: AA
authors.lastname: Jacinto
authors.forename: Celia B
authors.initials: CB
authors.lastname: Antonelli
authors.forename: Antonio Cassio A
authors.initials: AC
authors.lastname: Pellizzon
authors.forename: Elisa Y
authors.initials: EY
authors.lastname: Saito
authors.forename: João V
authors.initials: JV
authors.lastname: Salvajoli
mesh_terms: D000293:Adolescent; D001918:Brachytherapy / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy*; D016019:Survival Analysis; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome