Abstract
PurposeTo 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 and materialsEighteen 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.ResultsAfter 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%).ConclusionExcellent 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.
Highlights
A variety of radiotherapeutic approaches have been used in the adjuvant local management of soft tissue sarcoma (STS)
Excellent local control with tolerable side effects have been observed in a small group of paediatric patients with STS treated by high dose rate brachytherapy alone (HBRT) alone or in combination with external beam irradiation (EBRT)
In the current study we report our experience treating STS with HBRT in 18 patients who were submitted to BRT alone or in combination with EBRT
Summary
A variety of radiotherapeutic approaches have been used in the adjuvant local management of soft tissue sarcoma (STS). These include external beam irradiation (EBRT), brachytherapy (BRT), and intraoperative radiation therapy. BRT can reduce the dose of radiation to normal tissues and shortens the overall treatment time while maintaining a comparable high rate of local control. In children, limited data are available from series that include relatively small numbers of patients with different tumor types [6,7,8,9,10], the theoretical advantages of HBRT makes this treatment modality an interesting option to multidisciplinary management of STS. The clinical details of these patients and outcome are presented and discussed
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