Dammerer Dietmar, Neugebauer Johannes, Braito Matthias, Wagner Moritz, Neubauer Markus, Moser Lukas, Süß Markus, Liebensteiner Michael, Putzer David
Department of Orthopaedics and Traumatology, University Hospital Krems, 3500 Krems, Austria.
Department of Orthopaedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Cancers (Basel). 2023 May 21;15(10):2854. doi: 10.3390/cancers15102854.
According to the literature only sparse data are available on the use of high-dose-rate intraoperative brachytherapy (IOHDR-BT) as a boost to external-beam irradiation (EBRT) in combination with a wide resection in patients with high-grade soft tissue sarcomas (STS).
Applying a retrospective study design, we investigated all patients who between 2010 and 2016 underwent marginal resection of a high-grade STS and intraoperative radiotherapy, followed by EBRT. We included only patients with a traceable follow-up time of at least two years. Of 89 patients, 35 met our inclusion criteria and showed an average follow-up of four years.
We found an overall 2-year local control rate of 94.3%. The local recurrence rate for R0 resections was 6%, whereas recurrences occurred in 13% of R1 resections and in 100% of R2 resections. One affected patient received only intraoperative radiotherapy. The recurrence rate by tumour entity was 36% for LPS, 11% for myxofibrosarcoma and 17% for undifferentiated pleomorphic sarcoma.
The treatment regimen consisting of limb-preserving surgery, IORT and pre- or postoperative radiotherapy consistently shows excellent local control rates.
根据文献，关于高剂量率术中近距离放疗（IOHDR-BT）作为外照射放疗（EBRT）的补充，联合广泛切除治疗高级别软组织肉瘤（STS）患者的数据稀少。
采用回顾性研究设计，我们调查了2010年至2016年间所有接受高级别STS边缘切除及术中放疗，随后接受EBRT的患者。我们仅纳入随访时间至少可追溯两年的患者。89例患者中，35例符合我们的纳入标准，平均随访时间为四年。
我们发现总体2年局部控制率为94.3%。R0切除的局部复发率为6%，而R1切除的复发率为13%，R2切除的复发率为100%。1例受影响患者仅接受了术中放疗。按肿瘤类型划分的复发率，脂肪肉瘤（LPS）为36%，黏液纤维肉瘤为11%，未分化多形性肉瘤为17%。
由保肢手术、术中放疗（IORT）以及术前或术后放疗组成的治疗方案始终显示出优异的局部控制率。
