Early Complications of High-dose-rate Brachytherapy in Soft Tissue Sarcoma: A Comparison With Traditional External-beam Radiotherapy
Open Access
- 1 March 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 470 (3), 751-758
- https://doi.org/10.1007/s11999-011-2106-5
Abstract
Radiotherapy and surgery are routinely utilized to treat extremity soft tissue sarcoma. Multiple radiation modalities have been described, each with advantages and disadvantages, without one modality demonstrating clear superiority over the others. We determined the overall initial complication rate in patients receiving surgery and radiotherapy, which specific complications were found when comparing different modalities, and whether combination therapy increased the overall rate of complications compared with surgery and single-modality radiotherapy. We retrospectively reviewed the records of 190 patients who received external-beam radiotherapy (141 patients), high-dose-rate brachytherapy (37 patients), or both (12 patients). We evaluated 100 men and 90 women (mean age, 57 years; range, 18–94 years) for tumor size and subtype, comorbidities, stage, grade, margin of resection, type of adjuvant treatment, and complications. Minimum followup was 3 months (mean, 40 months; range, 3–155 months). The most frequent early complications in the high-dose-rate brachytherapy cohort were infection, cellulitis, and seroma and/or hematoma. In the external-beam radiotherapy cohort, chronic edema, fibrosis, and chronic radiation dermatitis were more frequently encountered. The total number of early complications and overall incidence of major complications requiring further surgery were similar among the three cohorts, but a larger number of patients in the high-dose-rate brachytherapy group required subsequent surgery for infection compared with the external-beam radiotherapy group. High-dose-rate brachytherapy decreases radiation exposure and allows shorter duration of treatment compared with traditional external-beam radiotherapy but has a higher perioperative wound complication rate. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.Keywords
This publication has 42 references indexed in Scilit:
- Perioperative Hyperfractionated High-Dose Rate Brachytherapy for the Treatment of Soft Tissue Sarcomas: Multicentric ExperienceAnnals of Surgical Oncology, 2009
- Impact of Intensity-Modulated Radiation Therapy on Local Control in Primary Soft-Tissue Sarcoma of the ExtremityJournal of Clinical Oncology, 2008
- Intraoperative Radiation TherapyJournal of Clinical Oncology, 2007
- Perioperative Interstitial Brachytherapy for Soft Tissue Sarcomas: Prognostic Factors and Long-Term Results of 155 PatientsAnnals of Surgical Oncology, 2006
- Late treatment–related complications in 214 patients with extremity soft-tissue sarcoma treated by surgery and postoperative radiation therapyThe American Journal of Surgery, 2006
- Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcomaRadiotherapy and Oncology, 2005
- Reconstruction After Soft Tissue Sarcoma Resection in the Setting of BrachytherapyAnnals of Plastic Surgery, 2004
- The influence of anatomic location on outcome in patients with soft tissue sarcoma of the extremityCancer, 2003
- Wound Complications of Adjuvant Radiation Therapy in Patients with Soft-Tissue SarcomasAnnals of Surgery, 1989
- Soft‐tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading systemInternational Journal of Cancer, 1984