ESTRO 2023

Session Item

Brachytherapy: Breast

Session Code: 7012

Session Type: Poster (Digital)

Track: Brachytherapy

HDR perioperative interventional radiotherapy (brachytherapy) in soft tissue sarcomas of extremities

, Italy

Presentation Number: PO-2128

Abstract

Abstract Title:

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.