Low dose-rate interstitial brachytherapy in soft tissue sarcomas.
Low dose-rate interstitial brachytherapy in soft tissue sarcomas.
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作者：
Rosenblatt E;Meushar N;Eidelman M;Kuten A
目的。评估 Ir-192 间质近距离放射治疗作为广泛局部切除的辅助手段作为软组织肉瘤功能保留策略的有效性。 主题和方法。从1993年9月到1998年4月，连续20名诊断为软组织肉瘤的患者接受了广泛局部切除和间质近距离放射治疗相结合的治疗。 16 名患者在术中进行了近距离放射治疗，而 4 名患者则在局部麻醉下于术后进行了植入。 20 名患者中有 11 名在植入后还接受了外照射放射治疗。 结果。经过平均 27 个月 (4-54) 的随访后，所有 20 名患者的局部控制率为 85% (17/20)。在 16 名术中植入的患者中，局部控制率为 94% (15/16)。在 4 名接受术后植入的患者中，局部控制率为 50% (2/4)。精算5年生存率为90%。 3例（15%）出现严重局部并发症。 结论。在 20 名软组织肉瘤患者中，广泛局部切除后进行低剂量率间质近距离放射治疗，局部控制率达 85%。 术中植入的局部控制率高于术后植入的局部控制率。
Purpose. To assess the effectiveness of Ir-192 interstitial brachytherapy as an adjunct to wide local excision as a functionsaving strategy for soft tissue sarcomas. Subjects and methods. From September 1993 to April 1998, 20 consecutive patients diagnosed with soft tissue sarcomas were treated with a combination of wide local excision and interstitial brachytherapy. In 16 patients brachytherapy was done as an intraoperative procedure, while in four, the implant was performed post-operatively under local anesthesia. Eleven of the 20 patients also received external beam radiotherapy following the implant. Results. After a mean follow-up of 27 months (4–54) the local control rate for all 20 patients was 85% (17/20). In the 16 patients who had an intra-operative implant, local control was 94% (15/16). In the four patients who underwent a post-operative implant, local control was 50% (2/4). Actuarial 5-year survival was 90%. There were three cases (15%) of severe local complications. Conclusions. Wide local excision followed by low dose rate intersitital brachytherapy have yielded a 85% local control rate in 20 patients with soft tissue sarcomas. Local control rates were higher when the implants were done as an intra-operative procedure than as a post-operative one.