INTERSTITIAL BRACHYTHERAPY IN SOFT TISSUE SARCOMA- A SINGLE INSTITUTE EXPERIENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 2
Abstract
BACKGROUND The objective of our study is to assess the local control of the disease, locoregional failure and complications following usage of interstitial HDR Brachytherapy alone or in combination with external beam radiation therapy in truncal or extremity soft tissue sarcomas. MATERIALS AND METHODS From January 2014 to January 2017, a retrospective cohort analysis was conducted in our institute with 18 patients who were suffering from truncal and extremity soft tissue sarcoma. They were managed with peri-operative (n=14) or post-operative (n=4) brachytherapy (BT) to a total dose of 35- 48 Gy at 3.5 to 4 Gy per fraction twice a day through an interfraction interval of 6 hours for a period of 5-6 days in Radical ISBT alone arm and five days after resection at a dose of 18 to 21 Gy as upfront boost at 3 to 3.5 Gy twice a day for 3-4 days using high dose rate brachytherapy (HDR) along with an external beam radiation dose of 46- 50 Gy which was given to the tumour bed after two to three weeks of Brachytherapy in Radical RT followed by ISBT arm. Statistical analysis of the results of this study was done using Kaplan Meier survival analysis and log rank test (p value=0.02). Median overall survival and survival among different stage groups studied were compared by using same statistical survival analysis. RESULTS Patients had a median follow up period of 24 months. The median age was 42 years (9-75 years) with male to female ratio of 1.6:1. One out of 18 patients developed local recurrence and another had a recurrence in the lung. The local control rate for two years was 88% and overall survival for 1 year was 100%. The overall survival (In months) among the patients in stage wise distribution were 25.33 ± 15.04, 15 ± 12.99 and 16.16 ± 6.79 for stages I, II and III respectively. The incidence of complications was minimal in our study. We encountered 4-cases (22%) of grade II toxicity in the form of subcutaneous fibrosis and cutaneous atrophy over the treated site. There was one case (5.5%) of grade IV toxicity in the form of wound dehiscence. CONCLUSION Surgical resection followed by HDR BT is associated with excellent early local tumour control. Optimal multidisciplinary management could improve survival.
Authors and Affiliations
Vijayasree T. N. , Saravanan S.
Keywords
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- EP ID EP553079
- DOI 10.14260/jemds/2019/30
- Views 57
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