Interventional radiotherapy (brachytherapy) achieves very good long‐term quality of life in children and adolescents with soft‐tissue sarcoma

Abstract

Background Effective local therapy (surgery, radiation) and systemic multidrug chemotherapy are mandatory for curing childhood sarcoma. The standard radiation therapy for pediatric patients with soft‐tissue sarcoma (STS) is external beam radiotherapy (EBRT). Because EBRT may cause long‐term side effects with adverse effects on the patients’ health and quality of life (QoL), alternative strategies are required. Interventional radiotherapy (IRT; brachytherapy) is established as a standard treatment for several tumors in adulthood. Single‐center series have reported low levels of late effects and improved QoL in survivors treated with IRT in childhood. However, IRT is still applied infrequently in pediatric patients. Methods Thirty patients with STS were treated with IRT between 1992 and 2012 at the University Hospital Schleswig Holstein, Germany. Five patients were lost to follow‐up, and 25 patients (mean age at time of data collection 24.8 years [range, 10.7‐36.1]) could be analyzed focusing on overall survival and QoL (EORTC‐C30 questionnaire). For more detailed information regarding general and health‐specific questions, a separate questionnaire was developed. Results Nineteen of 25 patients were alive 13.4 [1.6‐25.2] years after first cancer disease, and the three‐year overall survival was 76% (SE, 0.09). The score of QoL/global health status (76.2 [16.6‐100]) in our patients outvalues the European (66.1) and equals the German (75.9) reference value. Conclusion IRT is an effective treatment option for pediatric patients with localized STS. Its role among other radiation dose‐sparing techniques such as proton beam therapy has to be defined in prospective studies.

Intraoperative Brachytherapy Combined With Adjuvant Radiotherapy Shows Equal Results in the Treatment of Leiomyosarcoma on the Extremities Compared to Adjuvant Radiotherapy Only – A Multicentric Retrospective Analysis

“…The current golden standard treatment is marginal resection and (neo-) adjuvant RT. Even though timeconsuming, brachytherapy in association with adjuvant RT has been reported to obtain more local control with less complications (7,8,13,14). This multicenter study compared the different adjuvant options of RT and their consequences on local control and overall survival.…”

“…Disadvantages include postoperative infection, wound dehiscence and sometimes unclear margins (6). Intraoperative brachytherapy, described as an efficient complementary technique to surgery and adjuvant RT, is not widely used (7,8). Even though showing favorable results, this time-consuming technique also needs a special infrastructure, which is not present in every sarcoma center.…”