Perioperative high-dose-rate interstitial brachytherapy combined with external beam radiation therapy for soft tissue sarcoma

Sharma, Daya Nand; Deo, S. V. S.; Rath, G.K.; Shukla, Nootan Kumar; Bakhshi, Sameer; Gandhi, Ajeet Kumar; Julka, Pramod Kumar

doi:10.1016/j.brachy.2015.03.002

Cited by 11 publications

(6 citation statements)

References 24 publications

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“…In this study, complications with LDR were correlated with suboptimal implant geometry, while for HDR they were correlated with dose per fraction, total dose, and total biological equivalent dose [65]. Other studies of HDR-BT combined with EBRT have confirmed similar rates of acute and late toxicity [71], with the volume of tissue receiving >150% of the prescription dose being a possible predictor of toxicity, especially in the lower extremities [72].…”

Section: Brachytherapy (Bt)mentioning

confidence: 57%

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Callaghan

Hasibuzzaman

Rodman

et al. 2020

Cancers

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Historically, patients with localized soft tissue sarcomas (STS) of the extremities would undergo limb amputation. It was subsequently determined that the addition of radiation therapy (RT) delivered prior to (neoadjuvant) or after (adjuvant) a limb-sparing surgical resection yielded equivalent survival outcomes to amputation in appropriate patients. Generally, neoadjuvant radiation offers decreased volume and dose of high-intensity radiation to normal tissue and increased chance of achieving negative surgical margins—but also increases wound healing complications when compared to adjuvant radiotherapy. This review elaborates on the current neoadjuvant/adjuvant RT approaches, wound healing complications in STS, and the potential application of novel radioprotective agents to minimize radiation-induced normal tissue toxicity.

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Section: Brachytherapy (Bt)mentioning

confidence: 57%

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Callaghan

Hasibuzzaman

Rodman

et al. 2020

Cancers

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“…Furthermore, devascularization of surrounding tissue beds and increased graft or wound necrosis may also occur as the result of chemotherapy. 49 While patients younger than 30 years had increased rates of complication, concurrent associated factors of longer follow-up and a high proportion of disease requiring chemotherapy may have played a role in these findings. Despite this, it is important to highlight this risk of reoperation in younger patients in the pre-surgical discussion with patients and families.…”

Section: Discussionmentioning

confidence: 99%

Complications following allograft reconstruction for primary bone tumors: Considerations for management

Ippolito

Martinez

Thomson

et al. 2019

Journal of Orthopaedics

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The aim of this study was to investigate complication rates and types following allograft reconstruction and discuss unique considerations for management. Methods: Seventy-four consecutive patients underwent large segment allograft reconstruction following resection of primary musculoskeletal tumors from 1991 to 2016. Mean patient age was 32 ± 20 years (range, 5-71 years). Minimum follow-up was 2 years unless patients were lost to disease prior. Mean follow-up was 105 months. Results: Thirty-five patients had complications requiring subsequent surgery at a mean of 30 months (range, 1-146 months) post-operatively. Individual complication rates were 29%, 50%, and 42% for Allograft Prosthetic Composite, Intercalary, and Osteoarticular allograft reconstruction, respectively. Risk factors for complication included age less than 30 (OR 4.5; p = 0.002), male gender (OR 2.8; p = 0.031), chemotherapy (OR 4.4; p = 0.003), lower extremity disease (OR 3.4; p = 0.025). In patients with complications, limb-retention rate was 91% and mean MSTS scores were 23.6. Conclusion: Despite considerable complication rates, management with a systematic approach results in successful outcomes with limb-retention greater than 90% and mean MSTS scores of 79%. In carefully selected patients, allografts provide a reliable method of reconstruction with treatable complications occurring at a mean of 30 months.

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“…Major toxicity observed in this study was delayed wound healing in 5.7% of patients with common late toxicity being chronic skin/ subcutaneous fibrosis in 9.6% patients. [60] • Optimal diagnostic panel for synovial sarcoma includes EMA, BCL-2, MIC2, and CD34, with the addition of TLE1, a new sensitive marker for diagnosis of synovial sarcoma, as per study from TMH. A unique "weak to absent" expression of INI1/SMARCB1, is fairly specific for diagnosis of synovial sarcoma and can be useful especially in settings lacking molecular diagnostics • BRT alone or with EBRT has been evaluated in adjuvant settings in the treatment of STSs by Indian investigators with heartening results • On the evaluation of outcomes when BRT has been used for adjuvant treatment in pediatric STSs, LC has been found to be superior in patients with tumor size <5 cm, symptom duration <2 months, and lower histopathological tumor grade.…”

Section: Prognosis and Managementmentioning

confidence: 99%

Indian data on bone and soft tissue sarcomas: A summary of published study results

Ramaswamy

Rekhi

Bakhshi

et al. 2016

South Asian J Cancer

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Bone sarcomas are rare tumors, approximating 0.2% of all cancers, with osteosarcoma (OGS), chondrosarcoma, and Ewing sarcoma being the most common cancers in this subset. The formation of disease management groups/clinics focused on sarcomas has resulted in better understanding and management of these uncommon tumors. Multiple large-scale retrospective data from Tata Memorial Hospital (TMH) and All India Institute of Medical Sciences have reported outcomes comparable to Western data in the field of OGS and Ewing sarcoma, with interesting prognostic factors identified for further evaluation. Soft tissue sarcomas are a rare heterogeneous group of tumors, more than 50 different tumor entities. The common subtypes identified in India include Ewing sarcoma and synovial sarcoma. Valuable work regarding brachytherapy has been done by radiation oncologists from the TMH, especially in pediatric patients.

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Perioperative high-dose-rate interstitial brachytherapy combined with external beam radiation therapy for soft tissue sarcoma

Cited by 11 publications

References 24 publications

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

Complications following allograft reconstruction for primary bone tumors: Considerations for management

Indian data on bone and soft tissue sarcomas: A summary of published study results

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