HDR perioperative interventional radiotherapy (brachytherapy) in soft tissue sarcomas of extremities
PO-2128
Abstract
HDR perioperative interventional radiotherapy (brachytherapy) in soft tissue sarcomas of extremities
Authors: Nicola Dinapoli1, Bruno Fionda1, Valentina Lancellotta1, Elisa Placidi1, Gian Carlo Mattiucci2, Tommaso Greco3, Calogero Graci3, Carlo Perisano3, Vincenzo Valentini1, Giulio Maccauro3, Luca Tagliaferri1
1Fondazione Policlinico Universitario Agostino Gemelli IRCCS, U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Rome, Italy; 2Mater Olbia Hospital, Radiotherapy Department, Olbia, Italy; 3Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Traumatology, Rome, Italy
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Purpose or Objective
Adjuvant radiotherapy has proven to be particularly useful in case of Soft Tissue Sarcomas (STS) located in close relationship with the neurovascular structures, combining limb salvage strategy with the oncologic appropriate treatment. Aim of this paper is to present the results obtained with the use of HDR Interventional Radiotherapy (IRT, brachytherapy) followed external beam radiotherapy (ERT) in the multimodal treatment of STS of the extremities, in terms of Overall survival (OS), local recurrence (LR) and side effects.
Material and Methods
We retrospectively analyzed 16 cases of STS of the extremities treated, between January 2003 and January 2016, with large or marginal surgical excision and adjuvant treatment with HDR IRT followed by ERT.
Results
The mean time between surgical excision and HDR IRT treatment was 7 days (range 5-15 days), with mean number of treatment fractions 4 (range 3-5 fractions) and mean overall dose of 18,5 Gy (range 15-20 Gy). The median survival was 34 months with a local control of 81.3%. The only significant side effect was mild sclerosis of the subcutaneous tissue and alterations of skin trophism.
Conclusion
Multimodal treatment with limb salvage surgery, HDR IRT and ERT has shown, in our series, positive results in lesions with a high-grade of malignancy with positive or marginal resection margins, for which a higher dose of radiations as allowed by IRT is desirable.