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Journal of Contemporary Brachytherapy
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Interview with Professor Janusz Skowronek
ABS 2015
5/2018
vol. 10
 
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abstract:
Original paper

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

Kazi Sazzad Manir, Abhishek Basu, Krishnangshu B. Choudhury, Swapnendu Basu, Koushik Ghosh, Subir Gangopadhyay

J Contemp Brachytherapy 2018; 10, 5: 431–438
Online publish date: 2018/10/31
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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.

keywords:

Cobalt 60, interstitial brachytherapy, soft tissue sarcoma

references:
Burningham Z, Hashibe M, Spector L, Schiffman JD. The epidemiology of sarcoma. Clin Sarcoma Res 2012; 2: 14.
Lindberg RD, Martin RG, Romsdahl MM, Barkley HT Jr. Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer 1981; 47: 2391-2397.
Suit HD, Proppe KH, Mankin HJ, Wood WC. Preoperative radiation therapy for sarcoma of soft tissue. Cancer 1981; 47: 2269-2274.
Eilber FR, Mirra JJ, Grant TT et al. Is amputation necessary for sarcomas? A seven-year experience with limb salvage. Ann Surg 1980; 192: 431-438.
Rosenberg SA, Tepper J, Glatstein E et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 1982; 196: 305-315.
Hilaris BS, Shiu MH, Nori D et al. Limb-sparing therapy for locally advanced soft-tissue sarcomas. Endocuriether/Hyperthermia Oncol 1985; 1: 17-24.
Shiu MH, Hilaris BS, Harrison LB, Brennan MF. Brachytherapy and function-saving resection of soft tissue sarcoma arising in the limb. Int J Radiat Oncol Biol Phys 1991; 21: 1485-1492.
Harrison LB, Franzese F, Gaynor JJ, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcomas of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 1993; 27: 259-265.
Choudhury AJ, Laskar S, Badhwar R. Interstitial brachytherapy in soft tissue sarcomas The Tata Memorial Hospital experience. Strahlenther Onkol 1998; 174: 522-528.
Rosenblatt E, Meushar N, Bar-Deroma R et al. Interstitial brachytherapy in soft tissue sarcomas: The Rambam experience. Isr Med Assoc J 2003; 5: 547-551.
Laskar S, Bahl G, Muckaden MA et al. Interstitial brachytherapy for childhood soft tissue sarcoma. Pediatr Blood Cancer 2007; 49: 649-655.
Laskar S, Khanna N, Puri A et al. Interstitial brachytherapy for childhood soft tissue sarcomas: Long-term disease outcome and late effects. Int J Radiat Oncol Biol Phys 2014; 90: S113-114.
Cortesi A, Galuppi A, Frakulli R et al. Adjuvant radiotherapy with brachytherapy boost in soft tissue sarcoma. J Contemp Brachytherapy 2017; 9: 256-262.
Richter J, Baier K, Flentje M. Comparison of 60Co and 192Ir sources in high dose rate afterloading brachytherapy. Strahlenther Onkol 2008; 184: 187-192.
Strohmaier S, Zwierzchowski G. Comparison of 60Co and 192Ir sources in HDR brachytherapy. J Contemp Brachytherapy 2011; 3: 199-208.
Zakaria GA, Schütte W, Azhari HA. Dosimetry of HDR afterloading machines with Ir-192 and Co-60 sources: comparisons of different international protocols. Z Med Phys 2010; 20: 215-224.
Ntekim Al, Adenipekun AA, Akinlade Bl et al. High-dose-rate brachytherapy in the treatment of uterine cervical cancer using cobalt-60 radionuclide source: Three years treatment outcome. West Afri J Radiol 2014; 21: 21-25.
Basu S, Basu A, Ghosh K, Dutta S. A phase I feasibility study for HDR interstitial Brachytherapy using 60Co for different sites. Radiother Oncol 2012; 103 (Supplement 2): S166.
Wittekind C, Compton C, Quirkey P et al. A uniform residual (R) tumor classification. Cancer 2009; 115: 3483-3488.
Yang JC, Chang AE, Baker AR et al. Randomised prospective study of benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998; 16: 197-203.
Otal A, Richart J, Rodriguez S et al. A method to incorporate interstitial components into the TPS gynecologic rigid applicator library. J Contemp Brachytherapy 2017; 9: 59-65.
https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_50. Assessed on 5th September 2018.
 
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