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Related Experiment Video

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Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
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CivaSheet® use for soft tissue sarcoma: A single institution experience.

Crystal Seldon1, Julie G Grossman2, Gautam Shrivastava1

  • 1Department of Radiation Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL.

Brachytherapy
|June 4, 2023
PubMed
Summary

CivaSheet, a palladium-103 implantable device, shows potential for treating soft tissue sarcoma (STS) by delivering targeted radiation. Initial results indicate a 40% local recurrence rate and Grade 4 complications in some cases.

Keywords:
BrachytherapyCivaSheetSoft tissue sarcoma

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Devices

Background:

  • Soft tissue sarcoma (STS) presents treatment challenges, especially in patients who have reached maximum radiation tolerance.
  • Intraoperative radiation therapy (IORT) offers a method to deliver targeted radiation doses during surgery.
  • Palladium-103 (Pd-103) is a radioisotope used in brachytherapy for its dosimetric properties.

Purpose of the Study:

  • To evaluate the initial clinical experience and outcomes of using CivaSheet, an implantable intraoperative radiation therapy device utilizing palladium-103.
  • To assess the safety and efficacy of CivaSheet in patients with surgically resected soft tissue sarcomas.
  • To determine the local recurrence rates and complication profiles associated with CivaSheet placement.

Main Methods:

  • A retrospective chart review was conducted for patients with STS treated with surgical resection and CivaSheet placement between January 2018 and December 2019.
  • The CivaSheet device, containing palladium-103, delivered an average adjuvant radiation dose of 47 Gy to a depth of 5 mm.
  • Patient data included tumor location, size, surgical reconstruction methods, local recurrence, and complications.

Main Results:

  • Ten CivaSheets were implanted in nine patients with STS, with a mean follow-up of 27 months.
  • Tumor locations varied, including retroperitoneum, chest, groin, and lower extremity, with an average tumor size of 7.6 cm.
  • A local recurrence rate of 40% was observed. Grade 4 complications occurred in three patients, necessitating device removal, particularly in cases with prior radiation and flap reconstruction. Extremity tumors showed a high rate of Grade 4 adverse events.

Conclusions:

  • CivaSheet represents a novel approach for intraoperative radiation boost in STS patients.
  • While demonstrating potential, the observed local recurrence and complication rates warrant further investigation.
  • CivaSheet may be a viable alternative to traditional brachytherapy methods, but careful patient selection and monitoring are crucial.