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Interstitial brachytherapy in soft tissue sarcomas: the Rambam experience
Edward Rosenblatt1, Netanel Meushar, Raquel Bar-Deroma
1Brachytherapy Unit, Department of Oncology, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel. e_rosenblatt@rambam.health.gov.il
The Israel Medical Association Journal : IMAJ
|August 22, 2003
Summary
Interstitial brachytherapy combined with surgery offers excellent local control for soft tissue sarcomas. This approach achieved an 87.5% local control rate in a study of 32 patients.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Interstitial brachytherapy offers radiobiologic and technical advantages for soft tissue sarcoma treatment.
- It can be used alone or combined with external beam radiotherapy (EBRT).
Purpose of the Study:
- To review the experience of Rambam Medical Center with interstitial brachytherapy in soft tissue sarcoma treatment.
- Evaluate outcomes in 32 patients managed with surgery and brachytherapy.
Main Methods:
- 32 patients with soft tissue sarcomas underwent surgery and brachytherapy of the tumor bed, with or without EBRT.
- Brachytherapy catheters were placed intraoperatively in 27 patients and postoperatively in 5.
- Treatments included low dose-rate (Iridium-192) and high dose-rate brachytherapy.
Main Results:
- Median follow-up was 36 months, with an 87.5% overall local control rate.
- Local recurrence occurred in 13% of patients; lung metastasis in 19%.
- Five-year disease-free survival was 56%, and overall survival was 70%.
Conclusions:
- Wide local excision followed by interstitial brachytherapy yields a high local control rate (87.5%).
- The local complication rate was 16%, with severe wound complications in 16% and late toxicity in 19%.