Peri-Operative Brachytherapy In Soft-Tissue Sarcomas. Hospital USM Experience

B. M. Biswal, N. R. N. Idris, Zulmi Wan, W. Ismail, A. S. Halim
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引用次数: 1

Abstract

Overview: Radiotherapy is an important adjuvant modality in the management of extremity soft-tissue tumors. Interstitial brachytherapy implantation is a precise technique of delivering radiation that conforms to the tumor bed. Materials and Method:Selected extremity soft-tissue sarcomas were managed with wide-excision followed by preoperative implantation of brachytherapy catheters. The implant was irradiated 3-5 th day post-surgery to a dose of 3Gy BID for 3-5 days using high dose rate (HDR) system. Further additional external radiotherapy dose of 40- 50Gy in conventional fractionation was delivered to the tumor bed. Observations: 17 patients with soft tissue sarcoma were treated from 2001 to 2007.The median age of patient was 26 years (4-74 years) with male to female ratio of 12:5. Three out of 17 patients develop local recurrence and 7-patient relapse as lung metastases. At the time of reporting, 2-year local control rate was 88% and 24 month overall survival rate was 50%. The complication was minimal and manifested as subcutaneous fibrosis, pigmentation and wound dehiscence. Conclusions: Perioperative interstitial brachytherapy is an option of radiotherapy for better local control in high grade large volume and recurrent soft-tissue tumor. Proper case selection and optimal multidisciplinary management could improve survival in future.
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软组织肉瘤的围手术期近距离放疗。医院USM经验
综述:放射治疗是四肢软组织肿瘤治疗中一种重要的辅助方式。间质近距离放射治疗植入是一种精确的放射技术,它能使放射符合肿瘤床。材料与方法:对选择的肢体软组织肉瘤进行大面积切除,术前置入近距离放射线导管。术后3-5天,采用高剂量率(HDR)系统对种植体进行3Gy BID剂量照射3-5天。在常规分割的基础上再给予肿瘤床外放疗剂量40 ~ 50Gy。观察:2001 ~ 2007年共收治软组织肉瘤17例。患者中位年龄26岁(4 ~ 74岁),男女比例为12:5。17例患者中有3例局部复发,7例复发为肺转移。报告时,2年局部控制率为88%,24个月总生存率为50%。并发症极少,表现为皮下纤维化、色素沉着和创面裂开。结论:对于高级别、大体积、复发性软组织肿瘤,围手术期间质性近距离放疗能较好地局部控制。正确的病例选择和优化的多学科管理可以提高未来的生存率。
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