Interstitial brachytherapy for pediatric soft tissue sarcoma: Evolving practice over three decades and long-term...

Area of Science:

• Oncology
• Radiation Oncology
• Pediatric Oncology

Background:

• Soft tissue sarcomas (STS) are rare in children.
• Interstitial brachytherapy (BT) is a specialized radiation technique used in cancer treatment.
• Long-term outcomes and adverse effects of BT for pediatric STS require evaluation.

Purpose of the Study:

• To assess the long-term clinical outcomes of interstitial brachytherapy (BT) in pediatric soft tissue sarcomas (STS).
• To evaluate adverse effects associated with BT for pediatric STS.
• To understand the evolving practice of BT in managing pediatric STS.

Main Methods:

• A retrospective study included 105 children with STS treated between 1984 and 2014.
• Treatments involved wide local excision and interstitial brachytherapy (BT), with or without external beam radiotherapy (EBRT).
• Eighty-five percent (81%) of patients received BT alone.

Main Results:

• At 10-year follow-up, local control (LC) was 83%, disease-free survival (DFS) was 66%, and overall survival (OS) was 73%.
• Tumor size (<5 cm), Grade I/II, non-round cell histology, and trunk/extremity location were associated with superior LC.
• BT alone yielded comparable LC to BT with EBRT; LDR and HDR BT showed similar LC. Wound complications occurred in 6%, with late complications including fibrosis and edema.

Conclusions:

• Interstitial brachytherapy (BT), with or without external beam radiotherapy (EBRT), achieves excellent outcomes in pediatric soft tissue sarcomas (STS).
• Radical BT alone, when judiciously applied, results in excellent local control and function.
• This approach offers minimal treatment-related morbidity, highlighting its efficacy and safety.