Combined intraoperative and postoperative irradiation for soft tissue sarcomas

A major problem in the management of soft tissue sarcomas is the high rate of local recurrence postoperatively, regardless of whether the surgery performed was radical or conservative. The addition of irradiation to the tumor bed has decreased this risk significantly. In an attempt to achieve maximal local tumor control, a number of patients were treated by means of excisional surgery combined with an intraoperative implant and postoperative external irradiation. A new type of intraoperative irradiation procedure was used, in which iridium (192Ir) is inserted into afterloading nylon catheters which are implanted in the tumor bed at the time that the tumor is surgically excised.