Bone HDR brachytherapy in a patient with recurrent Ewing's sarcoma of the acetabulum: Alternative to aggressive surgery

Abstract

A 17-year-old girl diagnosed with a previously irradiated, locally recurrent Ewing's sarcoma involving the puboischiatic rami and the adjacent acetabulum was referred to our institution for consideration of salvage hindquarter resection. A conservative resection with implantation of the acetabular remnant for high-dose rate brachytherapy was performed instead. The patient died 11 months after surgery without signs or symptoms of bony damage and retained the ability to walk for the remainder of her life.

Interventional Oncology: Should Interventional Radiotherapy (Brachytherapy) be Integrated into Modern Treatment Procedures?

“…[9,[31][32][33] Treatments with favorable outcome were reported in different anatomic sites like head & neck-, bone-, liver-, soft tissue-and peripheral lung tumors or oligometastes. [9,[34][35][36][37][38][39][40] Recently, the advantage of a robotic implantation with the use of a personalized 3D printed template compared to the manual implantation with personalized 3D printed template guidance was documented. [41] Some groups use seed implants, other the HDR stepping source technology.…”

Metastatic Acetabular Fractures: Evaluation and Approach to Management

“…15 High-dose brachytherapy was successfully used in a previously radiated acetabulum without bone necrosis in a patient with locally recurrent sarcoma. 16 5. Injections: Methylmethacrylate and ethanol injections into the osteolytic lesion are palliative procedures with the aim of providing fast pain relief.…”