Adjuvant brachytherapy for treatment of chest wall sarcomas

Journal Article · Wed May 01 04:00:00 EDT 1991 · Journal of Thoracic and Cardiovascular Surgery; (USA)

OSTI ID:5544316

Wallner, K E; Nori, D; Burt, M; Bains, M; McCormack, P ^[1]

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1. Memorial Sloan-Kettering Cancer Center, New York, NY (USA)

Thirty patients treated with surgical resection and brachytherapy for chest wall sarcoma at Memorial Sloan-Kettering Cancer Center from 1980 through 1987 were reviewed. Patients selected to receive adjuvant irradiation were those for whom there was doubt as to the completeness of surgical resection. Overall 5-year survival and locoregional control after brachytherapy were 65% and 54%, respectively. Locoregional control was similar for tumors treated at initial diagnosis (12 patients), at the time of recurrence (13 patients), or for tumors that were metastatic to the chest wall (five patients). Six patients with tumors larger than 10 cm in maximum dimension had a locoregional recurrence rate of 69% versus a recurrence rate of 39% for 18 patients with smaller tumors (p = 0.27). Fifty-four percent of high-grade tumors recurred locoregionally versus 28% of low-grade tumors (p = 0.37). Bone invasion or the presence of positive resection margins was not clearly associated with a higher locoregional failure rate. Only one patient (1/28; 7%) was known to have had recurrence within the irradiated area. Eight patients (8/28; 37%) had recurrence adjacent to the implanted area, and the precise failure site could not be determined for the remaining two patients. Because of the relatively high risk of regional versus in-field recurrence, patients with chest wall sarcoma who receive adjuvant treatment should be treated primarily with external-beam irradiation to allow more generous coverage of the tumor bed. Brachytherapy could be used as a tumor bed 'boost' treatment. In patients undergoing resection of recurrent tumor in a previously irradiated site, adjuvant brachytherapy, without external-beam irradiation, should be considered to reduce the risk of extensive soft tissue necrosis.

• OSTI ID: 5544316
• Journal Information: Journal of Thoracic and Cardiovascular Surgery; (USA), Journal Name: Journal of Thoracic and Cardiovascular Surgery; (USA) Vol. 101:5; ISSN 0022-5223; ISSN JTCSA
• Country of Publication: United States
• Language: English

Related Subjects

550604* -- Medicine-- Unsealed Radionuclides in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BODY AREAS
CHEST
DISEASES
DOSES
IRIDIUM ISOTOPES
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
PATIENTS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
SARCOMAS
SURVIVAL CURVES
THERAPY