Control of locally advanced extremity soft tissue sarcomas by function-saving resection and brachytherapy

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Limb-sparing surgery for soft tissue sarcomas is challenging due to high local recurrence rates.
• Amputation has been the traditional treatment for bulky or deep-seated limb sarcomas.

Purpose of the Study:

• To evaluate the efficacy of function-preserving resection and high-dose brachytherapy for locally advanced limb sarcomas.
• To assess local control rates and limb function preservation after this combined treatment approach.

Main Methods:

• A study involving 33 patients with locally advanced limb sarcomas (17 untreated, 16 recurrent).
• Treatment involved function-preserving resection followed by high-dose Iridium-192 brachytherapy to the tumor bed.

Main Results:

• 100% local control in previously untreated patients; 62.5% in previously treated recurrent cases.
• Limb function (prehensile or walking) was preserved in 31 of 33 patients.
• Nine patients experienced serious wound complications, with two requiring secondary amputation.

Conclusions:

• Conservative resection and brachytherapy can achieve successful local control of advanced limb sarcomas.
• This approach allows for good preservation of limb function, offering an alternative to amputation.