Management of recurrent soft tissue sarcomas by conservative surgery and adjuvant intraoperative interstitial brachytherapy
Badhwar, R.; Chaudhary, A.J.; Bagdia, M.S.; Suraiya, J.N.
Indian Journal of Cancer 22(1): 38-45
1985
ISSN/ISBN: 0019-509X PMID: 3836953 Document Number: 259809
Soft tissue sarcomas are aggressive tumour and notorious for local recurrences. In the past amputation was considered as the treatment of choice for recurrent and locally advanced sarcomas of the extremity as conservative surgery was associated with a very high failure rate. It was observed that the excellent results of radical surgery can also be achieved with conservative surgery, when combined with high dose radiotherapy. But this high radiation dose when delivered by external beam alone carries a very high morbidity. In our series of 8 cases treated by limb sparing conservative surgery, a very high radiation dose (8000 to 9000 rads) was carefully delivered by intraoperative interstitial implants with iridium192 and supplementary teletherapy. There were no complications and 7 out of 8 patients are free of disease. The only patient who developed local recurrence after 8 months was subsequently salvaged by further surgery. Thus it can be concluded that the combined technique of brachytherapy and teletherapy for irradiating the tumour bed after limited excision not only achieves excellent local control, equivalent to that of radical surgery, but also provides a good functional and cosmetically acceptable limb therapy improving the quality of life.