Outcome Following the Wide Excision Combined with Postoperative Brachytherapy and External Beam Radiation in Soft Tissue Sarcoma of Extremities: Case Series
Keywords:
Soft tissue sarcoma, wide excision, Brachytherapy, Radiation, OutcomeAbstract
To study “Outcome following the wide excision combined with postoperative brachytherapy and external beam radiation (EBRT) in soft tissue sarcoma of extremities”. This is a prospective case series study of seven patients with soft tissue sarcoma of the extremities treated at Rajavithi Hospital. All patients underwent surgical by single oncologic-orthopedic surgeon and treated with wide excision combined with brachytherapy and radiation. Then the patienes were evaluated acute wound complication by Khaled score in admission and at 3 months after surgery. Late complication was evaluated from extremity edema, subcutaneous fibrous and joint stiffness by Stern ‘s rating scale at 6 months, 1 year and 1.5 year after surgery. Evaluation of recurrent rate was done at 1.5 year after treatment. All of patients were classified in high grades soft tissue sarcoma of extremities. Acute complication was found 2 patients which were mild wound complication (seroma 5ml and wound separate 5 cm). Late complications at 6 months were found 3 patients (42.85%) all have extremity edema, at 1 year were found 3 patients (42.85%) have 1 (14.28%) extremity edema, 1 (14.28%) subcutaneous fibrosis and 1 (14.28%) joint stiffness. The complications at 1.5 year were found 2 patients (28.57%) have 1 (14.28%) subcutaneous fibrosis and 1 (14.28%) joint stiffness. In the 1.5 year follow up, all patients were not found recurrence. Inconclusion, outcome following treatment of the wide excision combined with postoperative brachytherapy and radiation in soft tissue sarcoma of extremities were found complication frequently. Acute complications were wound complication mostly. Chronic complications were extremity edema, subcutaneous fibrosis and joint stiffness. From this study, the patients who underwent wide excision combined with postoperative brachytherapy and external beam radiation (EBRT) should be carefully treated and observed for prevent the complication.
References
Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998;16(1):197-203.
Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, 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(3):305-15.
Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long - term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996;14(3):859-68.
Schray MF, Gunderson LL, Sim FH, Pritchard DJ, Shives TC, Yeakel PD. Soft tissue sarcoma. Integration of brachytherapy, resection, and external irradiation. Cancer 1990;66(3):451-6.
Andrews SF, Anderson PR, Eisenberg BL, Hanlon AL, Pollack A. Soft tissue sarcomas treated with postoperative external beam radiotherapy with and without low - dose - rate brachytherapy. Int J Radiat Oncol Biol Phys 2004;59(2):475-80.
Nag S, Shasha D, Janjan N, Petersen I, Zaider M; American Brachytherapy Society. The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2001;49(4):1033-43.
Delannes M, Thomas L, Martel P, Bonnevialle P, Stoeckle E, Chevreau C, et al. Low-dose-rate intraoperative brachytherapy combined with external beam irradiation in the conservative treatment of soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2000;47(1):165-9.
Alekhteyar KM, Leung DH, Brennan MF, Harrison LB. The effect of combined external beam radiotherapy and brachytherapy on local control and wound complications in patients with high - grade soft tissue sarcomas of the extremity with positive microscopic margin. Int J Radiat Oncol Biol Phys 1996;36(2):321-4.
Stern TN. Clinical examination: a textbook for physical diagnosis. Chicago: Year Book Medical Publishers; 1964.
Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995;31(5):1341-6.
Ormsby MV, Hilaris BS, Nori D, Brennan MF. Wound complications of adjuvant radiation therapy in patients with soft - tissue sarcomas. Ann Surg 1989;210(1):93-9.
Trotti A. Toxicity in head and neck cancer: a review of trends and issues. Int J Radiat Oncol Biol Phys 2000;47(1):1-12.
Stinson SF, DeLaney TF, Greenberg J, Yang JC, Lampert MH, Hicks JE, et al. Acute and long - term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1991;21(6):1493-9.
Robinson MH, Spruce L, Eeles R, Fryatt I, Harmer CL, Thomas JM, et al. Limb function following conservation treatment of adult soft tissue sarcoma. Eur J Cancer 1991; 27(12):1567-74.
Alektiar KM, Brennan MF, Singer S. Influence of site on the therapeutic ratio of adjuvant radiotherapy in soft - tissue sarcoma of the extremity. Int J Radiat Oncol Biol Phys 2005;63(1):202-8.
Laskar S, Bahl G, Puri A, Agarwal MG, Muckaden M, Patil N, et al. Perioperative interstitial brachytherapy for soft tissue sarcomas: prognostic factors and long - term results of 155 patients. Ann Surg Oncol 2007;14(2):560-7.
Andrews SF, Anderson PR, Eisenberg BL, Hanlon AL, Pollack A. Soft tissue sarcomas treated with postoperative external beam radiotherapy with and without low - dose - rate brachytherapy. Int J Radiat Oncol Biol Phys 2004;59(2):475-80.
Beltrami G, Rüdiger HA, Mela MM, Scoccianti G, Livi L, Franchi A, et al. Limb salvage surgery in combination with brachytherapy and external beam radiation for high - grade soft tissue sarcomas. Eur J Surg Oncol 2008; 34(7):811-6.
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