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Chen Y, Ji Z, He C, Dai J, Zhang K, Li C, Song Y, Yan L, Ma Y, Jiang Y, Sun H, Wang R, Liang B, Chen G, Huang X, Wang J. Stereotactic ablative brachytherapy with or without assistance of 3D-printing templates for inoperable locally recurrent or oligometastatic soft-tissue sarcoma: a multicenter real-world study. Am J Cancer Res 2023; 13:6226-6240. [PMID: 38187073 PMCID: PMC10767329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
The management of inoperable locally recurrent or oligometastatic soft-tissue sarcoma (STS) remains a clinical challenge. This study aimed to explore the long-term outcomes of stereotactic ablative brachytherapy (SABT) for these patients. Patients diagnosed with inoperable locally recurrent or oligometastatic STS from eight hospitals between 2006 and 2021 underwent iodine-125 (I-125) seed SABT, either with or without the assistance of three-dimensional (3D)-printing templates. The analysis concentrated on several key parameters, including objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), adverse events (AEs), pain relief rate, and performance improvement rate. The ORR and DCR reached 78.3% and 95.0%, respectively. The results of multivariate logistic regression analysis indicated that a smaller tumor volume and a higher treatment dose were significantly associated with complete response (P < 0.001; P=0.036). The 1-, 3-, and 5-year LCT rates were 73.2%, 40.6%, and 37.9%, respectively. The 1-, 3-, and 5-year OS rates reached 83.1%, 50.5%, and 36.1%, respectively. Multivariate analysis revealed that a higher dose, a smaller tumor volume, and utilization of 3D-printing templates were significantly positive prognostic factors of LCT (P=0.006; P=0.007; P=0.034). Moreover, the tumor locations of trunk wall and extremities and lower tumor grade (G1/2) were significantly positive prognostic factors of survival (P=0.008; P=0.002). Pain relief rate was 88.0%, and the performance improvement rate was 46.7%. The AEs were predominantly of grade ≤ 2 and were well-tolerated. SABT seems to be an efficacious and safe alternative therapy for inoperable locally recurrent or oligometastatic STS.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third HospitalBeijing 100191, P. R. China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third HospitalBeijing 100191, P. R. China
| | - Chuang He
- Treatment Center of Minimally Invasive Intervention and Radioactive Particles, First Affiliated Hospital of The Army Medical UniversityChongqing 400038, P. R. China
| | - Jinzhao Dai
- Department of Nuclear Medicine, Qingdao Central HospitalQingdao 266300, Shandong, P. R. China
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People’s HospitalTengzhou 277500, Shandong, P. R. China
| | - Chuang Li
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian UniversityDalian 116000, Liaoning, P. R. China
| | - Yuqing Song
- Department of Radiation Oncology, Shuangluan District People’s HospitalChengde 067000, Hebei, P. R. China
| | - Lei Yan
- Jilin Provincial Key Laboratory of Radiation Oncology and Therapy, Department of Radiation Oncology and Therapy, The First Hospital of Jilin UniversityChangchun 130021, Jilin, P. R. China
| | - Yanli Ma
- Department of Radiation Oncology, Shuangluan District People’s HospitalChengde 067000, Hebei, P. R. China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third HospitalBeijing 100191, P. R. China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third HospitalBeijing 100191, P. R. China
| | - Ruoyu Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian UniversityDalian 116000, Liaoning, P. R. China
| | - Baosheng Liang
- Department of Biostatistics, School of Public Health, Peking UniversityBeijing 100191, P. R. China
| | - Guanglie Chen
- Department of Radiation Oncology, Tongliao City Keerqin District First People’s HospitalTongliao 028000, Inner Mongolia, P. R. China
| | - Xuequan Huang
- Treatment Center of Minimally Invasive Intervention and Radioactive Particles, First Affiliated Hospital of The Army Medical UniversityChongqing 400038, P. R. China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third HospitalBeijing 100191, P. R. China
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Chen Y, Dai J, Jiang Y, Ji Z, Jiang P, Sun H, Xu F, Wang J. Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study. J Pers Med 2021; 11:jpm11090839. [PMID: 34575616 PMCID: PMC8467951 DOI: 10.3390/jpm11090839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/12/2022] Open
Abstract
The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Jinzhao Dai
- Department of Nuclear Medicine, Qingdao Central Hospital, Qingdao 266300, China;
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
- Correspondence: ; Tel.: +86-137-0107-6310; Fax: +86-010-8226-5968
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Chen Y, Jiang Y, Ji Z, Jiang P, Xu F, Zhang Y, Zhang P, Guo F, Li X, Sun H, Lei R, Fan J, Li W, Huang Y, Wang J. Dosimetry, efficacy, and safety of three-dimensional printing noncoplanar template-assisted and CT-guided 125I seed implantation for recurrent retroperitoneal lymphatic metastasis after external beam radiotherapy. Brachytherapy 2020; 19:380-388. [PMID: 32249183 DOI: 10.1016/j.brachy.2020.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the dosimetry, efficacy, and safety of radioactive 125I seed implantation (RISI) assisted by three-dimensional printing noncoplanar template (3D-PNCT) and CT for recurrent retroperitoneal lymphatic metastasis (RRLM) after previous external beam radiotherapy. METHODS AND MATERIALS From June 2016 to August 2018, 32 patients with RRLM successfully underwent 3D-PNCT-assisted and CT-guided RISI. The dosimetry, pain relief rate, performance improvement rate, overall response rate, disease control rate, local control time (LCT), overall survival (OS), and safety profiles were evaluated. RESULTS Dosimetric results showed that the D90, D100, V100, V150, V200, and homogeneity index were consistent in preoperation and postoperation (p > 0.05), except for the external index and conformal index (p = 0.048, p = 0.034). After RISI, 81.3% of the patients achieved pain relief, and 71.9% achieved an improvement of performance. The overall response rate and disease control rate were 85.3% and 94.1%, respectively. The LCT rates reached 66.2% and 43.2% in 1 year and two years, respectively, with a median LCT of 15.8 months. The OS rates were 74.1% and 28.1% in 1 year and two year, respectively, with a median OS reaching 17.6 months. Univariate analysis showed that when D90 > 130 Gy or D100 > 63 Gy or tumor size ≤49.8 cm3, LCT was extended significantly, but not for OS. Except for two patients developing Grade 1 retroperitoneal hematomas, no other severe adverse events were observed. CONCLUSIONS 3D-PNCT and CT guidance provide excellent accuracy for RISI, which can be an effective and safe alternative for RRLM after external beam radiotherapy. Radiation dose and tumor size seem to significantly influence the local control.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yibao Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Pu Zhang
- Department of Radiation Oncology, Liaocheng People's Hospital, Liaocheng, Shandong Province, China
| | - Fuxing Guo
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Runhong Lei
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Weiyan Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuliang Huang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
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Chen Y, Jiang Y, Ji Z, Jiang P, Xu F, Zhang Y, Guo F, Peng R, Li X, Sun H, Lei R, Fan J, Li W, Wang J. Efficacy and safety of CT-guided 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma after surgery and external beam radiotherapy: A 12-year study at a single institution. Brachytherapy 2019; 19:81-89. [PMID: 31653566 DOI: 10.1016/j.brachy.2019.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the efficacy and safety of CT-guided radioactive 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma (HNSTS) after surgery and external beam radiotherapy. METHODS AND MATERIALS From December 2006 to February 2018, 25 patients with locally recurrent HNSTS after surgery and external beam radiotherapy were enrolled. All the patients successfully underwent CT-guided 125I seed implantation. The primary end points included the objective response rate (ORR) and local progression-free survival (LPFS). The secondary end points were survival (OS) and safety profiles. RESULTS After 125I seed implantation, the ORR was 76.0%. The 1-, 3-, and 5-year LPFS rates were 65.6%, 34.4%, and 22.9%, respectively, with the median LPFS of 16.0 months. The 1-, 3-, and 5-year OS rates were 70.8%, 46.6%, and 34.0%, respectively, with the median OS of 28.0 months. Furthermore, univariate analyses showed that the recurrent T stage and histological grade were prognostic factors of LPFS, whereas only the histological grade was a predictor of OS. The major adverse events were skin/mucosal toxicities, which were generally of lower grade (≤Grade 2) and were well tolerated. CONCLUSIONS Radioactive 125I seed implantation could be an effective and safe alternative treatment for locally recurrent HNSTS after failure of surgery and radiotherapy. Recurrent T stage and histological grade were the main factors influencing the efficacy.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yibao Zhang
- Department of Radiotherapy, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Fuxing Guo
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ran Peng
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Runhong Lei
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Weiyan Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
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Radiation Therapy for Sarcomas. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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García Del Muro X, Martín J, Maurel J, Cubedo R, Bagué S, de Álava E, Pousa AL, Narváez JA, Ortiz E, Pomés J, Poveda A, Romasanta LP, Tendero O, Viñals JM. [Soft tissue sarcomas: clinical practice guidelines]. Med Clin (Barc) 2011; 136:408.e1-8. [PMID: 21411112 DOI: 10.1016/j.medcli.2011.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 02/03/2011] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
Abstract
Soft tissue sarcomas (STS) constitute a rare heterogeneous group of tumours that include a wide variety of histological subtypes, which require a multidisciplinary and, frequently specialized and complex management. Despite advances in our understanding of the pathophysiology of the disease, there are no consensus multidisciplinary recommendations about its diagnosis and treatment in our country. The objective of these guidelines is to provide practical therapeutic recommendations that may contribute to improve the therapeutic results of this disease in our environment. With this purpose, the Spanish Group for Research in Sarcomas (GEIS) held a meeting with a multidisciplinary group of experts for the study and management of sarcomas. The results of this meeting are compiled in this document, in which recommendations on diagnosis, treatment and monitoring of soft tissue sarcomas are included. In summary, these guidelines aim to facilitate the identification and management of STS for clinical practice in Spain.
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Affiliation(s)
- Xavier García Del Muro
- Servicio de Oncología Médica, Instituto Catalán de Oncología L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, España.
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Adjuvant high dose rate brachytherapy for soft tissue sarcomas: initial experience report. J Contemp Brachytherapy 2011; 3:3-10. [PMID: 27877194 PMCID: PMC5108830 DOI: 10.5114/jcb.2011.21036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 03/12/2011] [Indexed: 11/17/2022] Open
Abstract
Purpose Adjuvant high-dose-rate brachytherapy (HDRBT) offers advantages over low dose rate brachytherapy (LDRBT), although there are little data on local tumor control and treatment related toxicity. We report outcome in patients with primary, recurrent, and metastatic extremity and superficial trunk soft tissue sarcoma. Material and methods Eleven patients (12 sites) with intermediate or high grade sarcoma were treated with adjuvant HDRBT following surgical resection. Patients were treated at 3.4 Gy fractions delivered twice daily to a total dose of 34 Gy (1 patient received 9 fractions). Results With median follow-up of 20.8 months, 1 patient developed a local recurrence. 2-year local control and overall survival are 89% and 71%, respectively. Wound complications occurred in 3 sites. Two of the wound complications developed in the area of previous external beam radiotherapy (EBRT). Conclusion Surgical resection followed by HDRBT is associated with excellent early local tumor control and acceptable wound complication.
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Pérez Romasanta LA, Montero Luis A, Verges Capdevila R, Mariño Cotelo A, Rico Pérez JM. Centralised treatment of soft tissue sarcomas in adults. Clin Transl Oncol 2008; 10:102-10. [PMID: 18258509 DOI: 10.1007/s12094-008-0162-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The clinical research developed in specialised centres and oncologic cooperative groups has permitted various scientific societies to collect recommendations used in the treatment of soft tissue sarcomas (STS) and incorporate them into clinical practice guidelines (CPG). Some studies have been conducted in diverse healthcare ambits to assess the influence of CPG. This revision of the medical literature analyses the impact that healthcare management -centralised or otherwise- and clinical practice in conformity with CPG have on the clinical outcome variables of STS. Eight CPG have been identified, as well as 12 conformity studies or audits. These conformity studies and audits demonstrate that the grade of adaptation of medical interventions with CPG, medical healthcare in reference centres and procedures of referrals to these centres, as well as the process of organising healthcare teams into Sarcoma Committees, have a significant influence on clinical outcome. We can conclude that excellent healthcare of STS implies the adaptation of healthcare practice to CPG, the existence of Reference Centres guided by Sarcoma Committees, and the observance of strict referral procedures within the Healthcare Area.
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Clarkson PW, Griffin AM, Catton CN, O'Sullivan B, Ferguson PC, Wunder JS, Bell RS. Epineural dissection is a safe technique that facilitates limb salvage surgery. Clin Orthop Relat Res 2005; 438:92-6. [PMID: 16131875 DOI: 10.1097/01.blo.0000180057.22712.53] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED Epineural dissection has been used in our center for the past 19 years as a means of preserving the sciatic nerve when it is closely applied to a soft tissue sarcoma. Our aim in doing this study was to establish if this technique resulted in increased local or systemic recurrence of the tumor. In addition, we assessed functional outcomes. Forty-three patients had an epineural dissection done during primary resection of a malignant thigh tumor. These patients were compared with 44 patients with tumors that were of similar size and grade but distant from the nerve. We also analyzed seven patients who required nerve resection. There was no difference in local or systemic recurrence rates or functional outcomes when epineural dissection was done. Those with nerve resection had worse Musculoskeletal Tumor Society scores but equivalent Toronto Extremity Salvage Scores to those with an epineural dissection. We conclude that epineural dissection (when combined with radiotherapy in a planned multidisciplinary approach to limb salvage) is both a safe and effective procedure to preserve the sciatic nerve and that nerve resection should be limited to situations where the nerve is completely encased in tumor. LEVEL OF EVIDENCE Prognostic study, Level II-2 (retrospective cohort study). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Paul W Clarkson
- University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
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Abstract
Perioperative brachytherapy results in a better local control rate than surgery alone for extremity soft tissue sarcoma. Brachytherapy enables the delivery of a high radiation dose to a limited volume of tissue, allows the reduction of radiation treatment time, enables direct visualization of the tumor bed and surrounding critical structures, and costs less than external beam radiotherapy. The literature seems to regard the effectiveness of brachytherapy as comparable to that of external beam radiotherapy, and the side effect profile is acceptable. Traditional low-dose-rate brachytherapy methods require extended periods of patient isolation, but recent technologic advances may obviate this necessity. Newer high-dose-rate (HDR) brachytherapy delivery methods allow for the fractionation of radiation delivery and outpatient treatment in some cases. Furthermore, with HDR brachytherapy, the radiation dose distribution can be tailored around critical anatomic structures. Although the application of HDR brachytherapy to soft tissue sarcoma is relatively new, it seems to result in a satisfactory local control rate and may replace traditional low-dose-rate techniques.
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Affiliation(s)
- Matthew T Ballo
- Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 97, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA.
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Nag S, Shasha D, Janjan N, Petersen I, Zaider M. The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2001; 49:1033-43. [PMID: 11240245 DOI: 10.1016/s0360-3016(00)01534-0] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This report presents the American Brachytherapy Society (ABS) guidelines for the use of brachytherapy for patients with soft tissue sarcoma. METHODS AND MATERIALS Members of the ABS with expertise in soft tissue sarcoma formulated brachytherapy guidelines based upon their clinical experience and a review of the literature. The Board of Directors of the ABS approved the final report. RESULTS Brachytherapy used alone or in combination with external beam irradiation is an established means of safely providing adjuvant local treatment after resection for soft tissue sarcomas in adults and in children. Brachytherapy options include low dose rate techniques with iridium 192 or iodine 125, fractionated high dose rate brachytherapy, or intraoperative high dose rate therapy. Recommendations are made for patient selection, techniques, dose rates, and dosages. Complications and possible interventions to minimize their occurrence and severity are reviewed. CONCLUSION Brachytherapy represents an effective means of enhancing the therapeutic ratio, offering both biologic and dosimetric advantage in the treatment of patients with soft tissue sarcoma. The treatment approach used depends upon the institution, physician expertise, and the clinical situation. Guidelines are established for the use of brachytherapy in the treatment of soft tissue sarcomas in adults and in children. Practitioners and cooperative groups are encouraged to use these guidelines to formulate their treatment and dose-reporting policies. These guidelines will be modified, as further clinical results become available.
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Affiliation(s)
- S Nag
- Ohio State University, Columbus, OH, USA.
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