Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2005

01-11-2005 | Original Articles

Pulsed Dose-Rate Perioperative Interstitial Brachytherapy for Soft Tissue Sarcomas of the Extremities and Skeletal Muscles of the Trunk

Authors: Gianluca Lazzaro, MD, PhD, Roberta Lazzari, MD, Giuseppe Pelosi, MD, Tommaso De Pas, MD, Luigi Mariani, MD, Giovanni Mazzarol, MD, Daniele Sances, MD, Giulio Tosti, MD, Federica Baldini, MD, Massimo Mosconi, MD, Ines Tedeschi, MSc, Giuseppe Viale, MD, Hugo Marsiglia, MD, Antonio Chiappa, MD, Andrea Vavassori, MD, Roberto Orecchia, MD, Alessandro Testori, MD

Published in: Annals of Surgical Oncology | Issue 11/2005

Login to get access

Abstract

Background

This study evaluated the role of pulsed dose-rate (PDR) brachytherapy (BRT), delivered alone or as a boost to external beam radiotherapy, as adjuvant therapy for the local control of soft tissue sarcomas of the extremities and skeletal muscles of the trunk that have undergone surgical treatment.

Methods

Between July 1998 and January 2002, 42 patients were treated with a combination of surgery and BRT alone (18 patients) or BRT/external beam radiotherapy (24 patients) for the treatment of primary (n = 32) and recurrent (n = 10) soft tissue sarcomas located in the proximal extremity (n = 17), distal extremity (n = 17), and trunk (n = 8). Tumor size was <5 cm in 20 cases and >5 cm in 22 cases, with histological grading of 1 (n = 7), 2 (n = 18), or 3 (n = 17). The median BRT dose delivered was 15 Gy, and the median external beam irradiation dose was 50 Gy.

Results

With a median follow-up of 34 months, the 36-month survival was 83.9% (SE, 6.1%), and the local control was 89%.

Conclusions

PDR interstitial BRT for soft tissue sarcoma is an effective, well-tolerated adjuvant radiation treatment that offers several practical advantages, among which are low acute and late toxicity with maximum normal tissue and critical structure sparing and overall shorter radiotherapy and hospital stay.
Literature
1.
Rosenberg SA, Tepper J, Glastein F, et al. The treatment of soft tissue sarcomas of the extremities: prospective randomized evaluation of: (1) limb sparing surgery plus radiotherapy compared with amputation and (2) the rate of adjuvant chemotherapy. Ann Surg 1982;136:305–15
2.
Crownover RL, et al. The radiobiology and physics of brachytherapy. Hematol Oncol Clin North Am 1999;13:477–87.CrossRef
3.
Chen CZ, Huang Y, Hall EJ, Brenner DJ. Pulsed brachytherapy as a substitute for continuous low dose rate: an in vitro study with human carcinoma cells. Int J Radiat Oncol Biol Phys 1997;37:137–43CrossRef
4.
Veninga T, Visser A, Van den Berg AP, Van Hooije CM, Van Geel CA, Levendag PC. Equivalence of hyperfractionated and continuous brachytherapy in a rat tumor model and remarkable effectiveness when preceded by external irradiation. Int J Radiat Oncol Phys 2001;49:1351–60CrossRef
5.
Swift PS, Purser P, Roberts LW, Pickett B, Powell B, Phillips TL. Pulsed low dose rate brachytherapy for pelvic malignancies. Int J Radiat Oncol Biol Phys 1997;37:811–7CrossRef
6.
Levendag PC, Schmitz PIM, Jansen PP, et al. Fractionated high-dose-rate and pulsed-dose-rate brachytherapy: first clinical experience in squamous cell carcinoma of the tonsillar fossa and soft palate. Int J Radiat Oncol Biol Phys 1997;38:497–506CrossRef
7.
Roed H, Engelholm SA, Svendsen LB, Rosendal F, Olsen KJ. Pulsed dose rate (PDR) brachytherapy of anal carcinoma. Radiother Oncol 1996;41:131–4CrossRef
8.
Fritz P, Berns C, Anton HW, et al. PDR brachytherapy with flexible implants for interstitial boost after breast-conserving surgery and external beam radiation therapy. Radiother Oncol 1997;45:23–32CrossRef
9.
Jensen PT, Roed H, Engelholm SA, Rosendal F. Pulsed dose rate (PDR) brachytherapy as salvage treatment of locally advanced or recurrent gynecologic cancer. Int J Radiat Oncol Biol Phys 1998;42:1041–7CrossRef
10.
Strnad V, Lotter M, Grabenbauer G, Sauer R. Early results of pulsed-dose-rate interstitial brachytherapy for head and neck malignancies after limited surgery. Int J Radiat Oncol Biol Phys 2000;46:27–30CrossRef
11.
Nag S, Shasha D, Janjan N, Petersen I, Zaider M. The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2001;49:1033–43CrossRef
12.
Nag S, Dobelbower R, Glasgow G, Gustafson G, Syed N, Thomadsen B, Willamson JW. Inter-society standards for the performance of brachytherapy: a joint report from ABS, ACMP, and ACRO. Crit Rev Oncol Hematol 2003;48:1–17
13.
Enzigher FM, Weiss SW. Soft Tissue Tumors. 2nd ed. St. Louis: Mosby, 1988
14.
Wambersie A, Dutreix A, Pierquin B, Dardenne JC. Dosimétrie prévisionnelle en thérapie interstitielle au moyen de fils d’iridium 192 (le ‘‘Système de Paris’’): application dans un plan. J Belge Radiol 1972;55:197–206
15.
Arbeit JM, Hilaris BS, Brennan MF. Wound complications in the multimodality treatment of extremity and superficial truncal sarcomas. J Clin Oncol 1987;5:480–8
16.
Marubini E, Valsecchi MG. Analyzing Survival Data From Clinical Trials and Observational Studies. Chichester: Wiley, 1995
17.
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–81
18.
Hilaris B, Shiu M, Nori D. Limb-sparing therapy for locally advanced soft tissue sarcomas. Endocur Hypertherm Oncol 1985;1:17–24
19.
Pisters P, Harrison L, Leung D, Woodruff J, Casper E, Brennan M. Long term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996;14:859–68
20.
Harrison LB, Franzese F, Gaynor JJ, Brennan MF. Long term results of prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcoma of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 1992;27:259–65
21.
de Pree C, Popowski Y, Weber D, Nouet P, Rouzaud M, Kurtz JM. Feasibility and tolerance of pulsed dose rate interstitial brachytherapy. Int J Radiat Oncol Biol Phys 1999;43:971–6CrossRef
Metadata
Title
Pulsed Dose-Rate Perioperative Interstitial Brachytherapy for Soft Tissue Sarcomas of the Extremities and Skeletal Muscles of the Trunk
Authors
Gianluca Lazzaro, MD, PhD
Roberta Lazzari, MD
Giuseppe Pelosi, MD
Tommaso De Pas, MD
Luigi Mariani, MD
Giovanni Mazzarol, MD
Daniele Sances, MD
Giulio Tosti, MD
Federica Baldini, MD
Massimo Mosconi, MD
Ines Tedeschi, MSc
Giuseppe Viale, MD
Hugo Marsiglia, MD
Antonio Chiappa, MD
Andrea Vavassori, MD
Roberto Orecchia, MD
Alessandro Testori, MD
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.11.004

Other articles of this Issue 11/2005

Annals of Surgical Oncology 11/2005 Go to the issue

Annual Heritage Presentation

Society of Surgical Oncology Heritage Award: Introduction—Honoring Samuel Alonzo Wells, Jr., MD

Original Articles

The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer

Erratum

Ann. Surg. Oncol., Vol. 12, No. 9, September 2005, pp. 705–711 (DOI: 10.1245/ASO.2005.08.020)

Letters to the Editor

Hepatic Resection at a Major Community-Based Teaching Hospital Can Result in Good Outcome

Letters to the Editor

Multidisciplinary Sequential Therapy for the Treatment of Peritoneal Surface Malignancies of Colorectal Origin: A Plea for Cooperation Between Medical and Surgical Oncologists

Educational Review

Germ Cell Tumors of the Testis