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עמוד בית
Mon, 15.07.24

Original Articles

IMAJ | volume

Journal 8, August 2003
pages: 547-551

Interstitial Brachytherapy in Soft Tissue Sarcomas: The Rambam Experience


    Background: There are radiobiologic and technical advantages to the use of interstitial brachytherapy alone or as an adjunct to external beam radiotherapy in the postoperative treatment of soft tissue sarcomas.

    Objectives: To review the experience of the Rambam Medical Center in implementing interstitial brachytherapy in the treatment of 32 patients with soft tissue sarcomas.

    Methods: Thirty-two patients with variously located soft tissue sarcomas were managed with a combination of surgery and brachytherapy of the tumor bed, with or without EBRT[1]. In 27 of 32 patients, brachytherapy catheters were placed intraoperatively, while in 5 patients the implant was performed as a separate postoperative procedure. Twenty-seven patients received low dose-rate brachytherapy with iridium-192 seeds. Five patients received fractionated high dose-rate brachytherapy using the microSelectron machine.

    Results: With a median follow-up of 36 months, the overall local control rate was 87.5%. Four of 32 patients (13%) failed locally at the implant site, and 6 (19%) developed lung metastasis. Two of the five patients with lung metastasis had a local recurrence as well. At the time of analysis, eight patients had died of sarcoma (disease-specific mortality rate was 25%), while three had died of intercurrent causes. The 5 year actuarial disease-free survival rate was 56%, and the 5 year actuarial overall survival was 70%. Five patients (16%) developed severe wound complications following surgery/brachytherapy, and six patients (19%) developed late local toxicity (fibrosis and telangiectasia).

    Conclusions: Wide local excision followed by interstitial brachytherapy has resulted in an 87.5% local control rate with a 17% local complication rate.

    [1] EBRT = external beam radiotherapy

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