Interstitial brachytherapy in soft tissue sarcoma: a 5 years institutional experience with Cobalt 60-based high-dose-rate brachytherapy system.

Abstract:

Purpose:Soft tissue sarcoma (STS) is rare but aggressive neoplasm. Interstitial brachytherapy (ISBT) alone or combined with external beam radiotherapy (EBRT) as post-operative treatment improves loco-regional (LRC) and distant control. Material and methods:Out of twenty-nine non-metastatic STS (lower limb 64%) patients (median age 37 yrs), treated with surgery and post-operative ISBT during February 2011 - December 2016, 27 patients with > 6 months follow-up were analyzed. Spindle cell sarcoma was the commonest (24%) histology. Eleven patients (44%) received EBRT (45-50 Gy), where ISBT was used as boost (16-20 Gy). Fourteen patients (56%) received ISBT alone (4 Gy per fractio). Treatment was done with a 60 Cobalt (60Co) source high-dose-rate system. Results:With a median follow-up of 20 months (17-51 months), LRC rate was 85.7% (with EBRT 90.5% and ISBT 83.2% alone). Median disease-free survival (DFS) was 39.7 ±3.9 months (32-47.2 months). Median loco-regional failure-free survival (LRRFS) was 43.8 ±3.6 months (36.8-50.9 months). Distant failure-free survival (DFFS) was 18 months (15.5-26.6 months). Overall survival was 42.4 ±3.4 months (35.7-48.1 months). Tumor grade was a significant factor for DFFS. Total radiation dose (including EBRT) has significant influence on DFS and LRRFS. 14.8% patients developed ≥ grade 2 late toxicity (skin atrophy, hypo-pigmentation, and telangiectasia). Conclusions:Combination of surgery and ISBT with/out EBRT improves local and distant control with acceptable late toxicities. 60Co-based ISBT is safe and gives a good outcome.

authors

Manir KS,Basu A,Choudhury KB,Basu S,Ghosh K,Gangopadhyay S

doi

10.5114/jcb.2018.78994

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

431-438

issue

5

eissn

1689-832X

issn

2081-2841

pii

33986

journal_volume

10

pub_type

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