Experience of interstitial permanent i(125) brachytherapy for extremity soft tissue sarcomas

Soft tissue sarcomas are uncommon, but relatively aggressive tumours. Although surgical resection remains the primary therapeutic modality for all localised tumours, brachytherapy combined with function-preserving excision is a popular treatment for extremity soft tissue sarcomas. The objective of this study was to evaluate the effect of interstitial permanent brachytherapy using I(125) seeds in patients undergoing the combined modality in the management of soft tissue sarcomas at our institution.

Between January 2007 and January 2012, 110 adult patients aged 18-86 years (median = 44 years) with extremity soft tissue sarcomas and who underwent interstitial permanent brachytherapy as part of the local treatment were included in this study. Treatment included wide local excision of the tumour and brachytherapy using a permanent I(125) implantation. Complications were assessed in terms of wound complication and peripheral nerve damage.

After a median follow-up of 43.7 months, the local control, disease-free survival and overall survival for the entire cohort studied were 74, 54 and 77%, respectively. The actual rates of wound complications requiring reoperation and nerve damage were 4.5 and 1.8%, respectively.

We conclude that interstitial permanent brachytherapy with I(125) after function-preserving surgery results in a satisfactory outcome in patients with extremity soft tissue sarcomas and the complication rate is low.