Low-dose-rate intraoperative brachytherapy combined with external beam irradiation in the conservative treatment of soft tissue sarcoma
| Autor: | B. Bui, Ch Chevreau, Jacques Pigneux, Martine Delannes, P Bonnevialle, Luc Thomas, P. Martel, N. Daly-Schveitzer, Guy Kantor, E. Stoeckle |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Brachytherapy Intraoperative Period Humans Medicine Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Aged 80 and over Radiation business.industry Soft tissue sarcoma Soft tissue Radiotherapy Dosage Sarcoma Middle Aged Iridium Radioisotopes Neurovascular bundle medicine.disease Combined Modality Therapy Survival Analysis Surgery Radiation therapy Oncology Amputation Female Implant Radiology business Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 47:165-169 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/s0360-3016(99)00548-9 |
| Popis: | Purpose: Conservative treatment of soft tissue sarcomas most often implies combination of surgical resection and irradiation. The aim of this study was to evaluate low-dose-rate intraoperative brachytherapy, delivered as a boost, in the local control of primary tumors, with special concern about treatment complications. Methods and Materials: Between 1986 and 1995, 112 patients underwent intraoperative implant. This report focuses on the group of 58 patients with primary sarcomas treated by combination of conservative surgery, intraoperative brachytherapy, and external irradiation. Most of the tumors were located in the lower limbs (46/58—79%). Median size of the tumor was 10 cm, most of the lesions being T2–T3 (51/58—88%), Grade 2 or 3 (48/58—83%). The mean brachytherapy dose was 20 Gy and external beam irradiation dose 45 Gy. In 36/58 cases, iridium wires had to be placed on contact with neurovascular structures. Results: With a median follow-up of 54 months, the 5-year actuarial survival was 64.9%, with a 5-year actuarial local control of 89%. Of the 6 patients with local relapse, 3 were salvaged. Acute side effects, essentially wound healing problems, occurred in 20/58 patients, late side effects in 16/58 patients (7 neuropathies G2 to G4). No amputation was required. The only significant factor correlated with early side effects was the location of the tumor in the lower limb ( p = 0.003), and with late side effects the vicinity of the tumor with neurovascular structures ( p = 0.009). Conclusion: Brachytherapy allows early delivery of a boost dose in a reduced volume of tissue, precisely mapped by the intraoperative procedure. Combined with external beam irradiation, it is a safe and efficient treatment technique leading to high local control rates and limited functional impairment. |
| Databáze: | OpenAIRE |
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