Skip to main content

Soft Tissue Sarcoma Brachytherapy

  • Chapter
  • First Online:
Brachytherapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 1305 Accesses

Abstract

Soft tissue sarcomas (STS) are a diffuse group of malignancies that arise from connective tissues such as fat, muscle, nerves, and blood vessels. They account for approximately 1 % of all adult malignancies and approximately 10 % of pediatric malignancies. They do not respect age, appearing in all age groups. Here we present brachytherapy as primary therapy or an adjunct to management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Morgagni G. De Sedibus, Et Causis Morborum Per Anatomen Indagatis Libri Quinque. Published 1761 by Ex Typographia Rmondiniana in Venetiis. Written in Latin

    Google Scholar 

  2. Gronchi A, Casali PG (2013) Adjuvant therapy for high-risk soft tissue sarcoma in the adult. Curr Treat Options Oncol 14(3):415–424. doi:10.1007/s11864-013-0243-7

    Article  PubMed  Google Scholar 

  3. Cancer Facts & Figures 2014. American Cancer Society

    Google Scholar 

  4. Fong Y, Coit DG, Woodruff JM et al (1993) Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 217(1):72–77

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Nelen SD, Vogelaar FJ, Gilissen F et al (2013) Case report, lymph node metastasis after a soft tissue sarcoma of the leg: a case report and a review of the literature. Case Rep Surg 2013:930361. http://dx.doi.org/10.1155/2013/930361

    Google Scholar 

  6. Mazeron JJ, Suit HD (1987) Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer 60(8):1800–1808

    Article  CAS  PubMed  Google Scholar 

  7. Daigeler A, Kuhnen C, Moritz R et al (2009) Lymph node metastases in soft tissue sarcomas: a single center analysis of 1,597 patients. Arch Surg 394(2):321–329

    Article  CAS  Google Scholar 

  8. Billingsley KG, Lewis JJ, Leung DH et al (1999) Multifactorial analysis of the survival of patients with distant metastasis arising from primary extremity sarcoma. Cancer 85(2):389–395

    Article  CAS  PubMed  Google Scholar 

  9. Pisters PW, Leung DH, Woodruff J et al (1996) Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol 14(5):1679–1689

    CAS  PubMed  Google Scholar 

  10. Wexler LH, Helman LJ (1994) Pediatric soft tissue sarcomas. CA Cancer J Clin 44(4):211–247

    Article  CAS  PubMed  Google Scholar 

  11. Neville HL, Raney RB, Andrassy RJ et al (2000) Multidisciplinary management of pediatric soft-tissue sarcoma. Oncology 14(10):1471–1481; discussion 1482–1486, 1489–1490

    CAS  PubMed  Google Scholar 

  12. Spunt S, Catherine S, Poquette A et al (1999) Prognostic factors for children and adolescents with surgically resected nonrhabdomyosarcoma soft tissue sarcoma: an analysis of 121 patients treated at St Jude Children’s Research Hospital. J Clin Oncol 17(2):3697–3705

    CAS  PubMed  Google Scholar 

  13. Zahm SH, Fraumeni JF (1997) The epidemiology of soft tissue sarcoma. Semin Oncol 24(5):504–514

    CAS  PubMed  Google Scholar 

  14. Ferrari A, Bisogno G, Macaluso A (2007) Soft-tissue sarcomas in children and adolescents with neurofibromatosis type 1. Cancer 109(7):1406–1412

    Article  PubMed  Google Scholar 

  15. Campos FG, Martinez C, Novaes M et al (2015) Desmoid tumors: clinical features and outcome of an unpredictable and challenging manifestation of familial adenomatous polyposis. Cancer 14(2):211–219

    Google Scholar 

  16. Goto M, Miller RW, Ishikawa Y et al (1996) Excess of rare cancers in Werner syndrome (adult progeria). Cancer Epidemiol Biomarkers Prev 5(4):239–246

    CAS  PubMed  Google Scholar 

  17. Kleinerman RA, Schonfeld SJ et al (2012) Sarcomas in hereditary retinoblastoma. Clin Sarcoma Res 2(1):15. doi:10.1186/2045-3329-2-15

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Cohen RJ, Curtis RE, Inskip PD et al (2005) The risk of developing second cancers among survivors of childhood soft tissue sarcoma. Cancer 103(11):2391–2396

    Article  PubMed  Google Scholar 

  19. McClain KL, Leach CT, Jenson HB et al (1995) Association of Epstein-Barr virus with leiomyosarcomas in children with AIDS. N Engl J Med 332(1):12–18

    Article  CAS  PubMed  Google Scholar 

  20. Schwarzbach MH, Dimitrakopoulou-Strauss A, Willeke F et al (2000) Clinical value of [18-F] fluorodeoxyglucose positron emission tomography imaging in soft tissue sarcomas. Ann Surg 231(3):380–386

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. O’Donnell PW, Griffin AM, Eward WC et al (2014) The effect of the setting of a positive surgical margin in soft tissue sarcoma. Cancer 120(18):2866–2875

    Article  PubMed  Google Scholar 

  22. Zagars GK, Ballio MT, Pisters PW et al (2003) Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer 97(10):2530–2543

    Article  PubMed  Google Scholar 

  23. Rosenberg SA, Tepper J, Glatstein E et al (1982) The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 196(3):305–315

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Swallow CJ, Catton CN (2007) Local management of adult soft tissue sarcomas. Semin Oncol 34(3):256–269

    Article  PubMed  Google Scholar 

  25. Levine EA (1999) Prognostic factors in soft tissue sarcoma. Semin Surg Oncol 17(1):23–32

    Article  CAS  PubMed  Google Scholar 

  26. Jones NB, Iwenofu H, Scharschmidt T et al (2012) Prognostic factors and staging for soft for soft tissue sarcomas: an update. Surg Oncol Clin N Am 21(2):187–200. doi:10.1016/j.soc.2011.12.003, Epub 2012 Jan 9

    Article  PubMed  Google Scholar 

  27. Baldini EH, Goldberg J, Jenner C et al (1999) Long-term outcomes after function-sparing surgery without radiotherapy for soft tissue sarcoma of the extremities and trunk. Clin Oncol 17(10):3252–3259

    CAS  Google Scholar 

  28. Curtis KK, Ashman JB, Beauchamp CP et al (2011) Neoadjuvant chemoradiation compared to neoadjuvant radiation alone and surgery alone for Stage II and III soft tissue sarcoma of the extremities. Radiat Oncol 6:91. doi:10.1186/1748-717X-6-91

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fein DA, Lee WR, Lanciano RM (1995) Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation: Do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local Control? Int J Radiati Oncol Biol Phys 32(4):969–976

    Article  CAS  Google Scholar 

  30. Cai L, Mirimanoff RO, Mouhsine E et al (2013) Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients. Rare Tumors 5(4):e55. doi:10.4081/rt.2013.e55

    Article  PubMed  PubMed Central  Google Scholar 

  31. Folkert MR, Singer S, Brennan MF et al (2014) Comparison of local recurrence with conventional and intensity-modulated radiation therapy for primary soft-tissue sarcomas of the extremity. J Clin Oncol 32(29):3236–3241. doi:10.1200/JCO.2013.53.9452

    Google Scholar 

  32. Pan E, Goldberg SI, Chen YL et al (2014) Role of post-operative boost for soft tissue sarcomas with positive margins following pre-operative radiation and surgery. J Surg Oncol 110(7):817–822. doi:10.1002/jso.23741, Epub 2014 Aug 11

    Article  PubMed  Google Scholar 

  33. Dincbas FO, Oksuz DC, Yetmen O et al (2014) Neoadjuvant treatment with preoperative radiotherapy for extremity soft tissue sarcomas; long-term results from a single institution in Turkey. Asian Pac J Cancer Prev 15(4):1775–1781

    Article  PubMed  Google Scholar 

  34. Mullen JT, Kobayashi W, Wang JJ et al (2012) Long-term follow-up of patients treated with neoadjuvant chemotherapy and radiotherapy for large, extremity soft tissue sarcomas. Cancer 118(15):3758–3765. doi:10.1002/cncr.26696

    Article  PubMed  Google Scholar 

  35. Look Hong NJ, Hornicek F, Harmon DC et al (2013) Neoadjuvant chemoradiotherapy for patients with high-risk extremity and truncal sarcomas: a 10 year single institution retrospective study. Eur J Cancer 49(4):875–883. doi:10.1016/j.ejca.2012.10.002

    Article  PubMed  PubMed Central  Google Scholar 

  36. Felderhof JM, Creutzberg CL, Putter H et al (2013) Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy. Acta Oncol 52(4):745–752. doi:10.3109/0284186X.2012.709947

    Article  PubMed  Google Scholar 

  37. Trovik CS, Scandinavian Sarcoma Group Project (2001) Local recurrence of soft tissue sarcoma. A Scandinavian Sarcoma Group Project. Acta Orthop Scand Suppl 72(300):1–31

    CAS  PubMed  Google Scholar 

  38. ESMO/European Sarcoma Network Working Group (2014) ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Soft tissue and visceral sarcomas. Ann Oncol 25(Suppl 3):iii102–iii112. doi:10.1093/annonc/mdu254

    Article  Google Scholar 

  39. Holloway C, DeLaney T, Alektiar KM et al (2013) American Brachytherapy Society (ABS) consensus statement for sarcoma brachytherapy. Brachytherapy 12:179–190

    Article  PubMed  Google Scholar 

  40. Grimer R, Judson I, Peake D et al (2010) Guidelines for the management of soft tissue sarcomas: British Sarcoma Group. Sarcoma 2010:506182. doi:10.1155/2010/506182

    PubMed  PubMed Central  Google Scholar 

  41. Lartigau E, Gerbaulet A (2002) GEC/ESTRO soft tissue sarcomas of the extremities in adults. ACCO, Leuven, Belgium. GEC-ESTRO Handbook 2002

    Google Scholar 

  42. NCCN Guidelines; Version 2 (2014) National comprehensive cancer network, soft tissue sarcoma. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

  43. Ren C, Shi R, Min L et al (2014) Experience of interstitial permanent I 125 brachytherapy for extremity soft tissue sarcomas. Clin Oncol 26(4):230–235. doi:10.1016/j.clon.2014.01.004

    Article  CAS  Google Scholar 

  44. Rosenblatt E, Meushar N, Bar-Deroma R et al (2003) Interstitial brachytherapy in soft tissue sarcomas: the Rambam experience. Isr Med Assoc J 5(8):547–551

    PubMed  Google Scholar 

  45. Petera J, Soumarova R, Ruzickova J et al (2010) Perioperative hyperfractionated high-dose rate brachytherapy for the treatment of soft tissue sarcomas: a multicentric experience. Ann Surg Oncol 17(1):206–210. doi:10.1245/s10434-00-0684-1

    Article  PubMed  Google Scholar 

  46. Itami J, Sumi M, Beppu Y (2010) High-dose rate brachytherapy alone in postoperative soft tissue sarcomas with close or positive margins. Brachytherapy 9(4):349–353. doi:10.1016/j.brachy.2009.07.012

    Article  PubMed  Google Scholar 

  47. San Miguel I, San Julian M, Cambeiro M et al (2011) Determinants of toxicity, patterns of failure, and outcome among adult patients with soft tissue sarcomas of the extremity and superficial trunk treated with greater that conventional doses of perioperative high-dose-rate brachytherapy and external beam radiotherapy. Int J Radiat Oncol Biol Phys 81(4):e529–e539. doi:10.1016/j.ijrobp.2011.04.063

    Article  PubMed  Google Scholar 

  48. Fairweather M, Wang J, Devlin PM et al (2015) Safety and efficacy of radiation dose delivered via Iodine-125 brachytherapy mesh implantation for deep cavity sarcomas. Ann Surg Oncol 22(5):1455–1463

    Article  PubMed  Google Scholar 

  49. Alektiar KM, Leung DH, Brennan MF et al (1996) The effect of combined external beam radiotherapy and brachytherapy on local control and wound complications in patients with high-grade soft tissue sarcomas of the extremity with positive microscopic margin. Int J Radiat Oncol Biol Phys 36(2):321–324

    Article  Google Scholar 

  50. Youssef E, Fontanesi J, Mott M et al (2002) Long-term outcome of combined modality therapy in retroperitoneal and deep-trunk soft-tissue sarcoma: analysis of prognostic factors. Int J Radiat Oncol Biol Phys 54(2):514–519

    Article  PubMed  Google Scholar 

  51. Pisters PW, Harrison LB, Leung DH et al (1996) Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. Clin Oncol 14(3):859–868

    CAS  Google Scholar 

  52. Beltrami G, Rὔdiger HA, Mela MM et al (2008) Limb salvage surgery in combination with brachytherapy and external beam radiation for high-grade soft tissue sarcomas. Eur J Surg Oncol 34(7):811–816

    Article  CAS  PubMed  Google Scholar 

  53. Alektiar K, Zelefsky M, Brennan M (2000) Morbidity of adjuvant brachytherapy in soft tissue sarcoma of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 47(5):1273–1279

    Article  CAS  PubMed  Google Scholar 

  54. Dörr W, Kallfels S, Herrmann T (2013) Late bone and soft tissue sequelae of childhood radiotherapy. Relevance of treatment age and radiation dose in 146 children treated 1970 and 1997. Strahlenther Onkol 189(7):529–534. doi:10.1007/s00066-013-0361-y

    Article  PubMed  Google Scholar 

  55. Paulino AC (2004) Late effects of radiotherapy for pediatric extremity sarcomas. Int J Radiat Oncol Biol Phys 60(1):265–274

    Article  PubMed  Google Scholar 

  56. Hennewig U, Kaatsch P, Blettner M et al (2014) Local radiation dose and solid second malignant neoplasms after childhood cancer in Germany: a nested case-control study. Radiat Environ Biophys 53(3):485–493. doi:10.1007/s00411-014-0550-9

    Article  CAS  PubMed  Google Scholar 

  57. Guerin S, Guibout C, Shamsaldin A et al (2007) Concomitant chemo-radiotherapy and local dose of radiation as risk factors for second malignant neoplasms after solid cancer in childhood: a case-control study. Int J Cancer 120(1):96–102

    Article  CAS  PubMed  Google Scholar 

  58. Krasin MJ, Davidoff AM, Xiong X et al (2010) Preliminary results from a prospective study using limited margin radiotherapy in pediatric and young adult patients with high-grade nonrhabdomyosarcoma soft-tissue sarcoma. Int J Radiat Oncol Biol Phys 76(3):874–878. doi:10.1016/j.ijrobp.2009.02.074

    Article  PubMed  PubMed Central  Google Scholar 

  59. Rodeberg RD, Wharam MD, Lyden ER et al (2015) Delayed primary excision with subsequent modification of radiotherapy dose for intermediate-risk rhabdomysarcoma: a report from the Children’s Oncology Group Soft Tissue Sarcoma Committee. Int J Cancer 137(1):204–211. 2014 UICC. doi:10.1002/ijc.29351

    Google Scholar 

  60. Cecchetto G, Modesto CM, Sotti G et al (2000) Importance of local treatment in pediatric soft tissue sarcomas with microscopic residual after primary surgery: results of the Italian Cooperative Study RMS-88. Med Pediatr Oncol 34:97–101

    Article  CAS  PubMed  Google Scholar 

  61. Gerbaulet A, Panis X, Flamant F, Chassagne D (1985) Iridium afterloading curietherapy in the treatment of pediatric malignancies. The Institut Gustave Roussy experience. Cancer 56(6):1274–1279

    Article  CAS  PubMed  Google Scholar 

  62. Fontanesi J, Rao BN, Fleming ID et al (1994) Pediatric brachytherapy. The St. Jude Children’s Research Hospital experience. Cancer 74(2):733–739

    Article  CAS  PubMed  Google Scholar 

  63. Merchant TE, Parsh N, del Valle PL et al (2000) Brachytherapy for pediatric soft-tissue sarcoma. Int J Radiat Oncol Biol Phys 46(2):427–432

    Article  CAS  PubMed  Google Scholar 

  64. Pötter R, Knocke TH, Kovacs G et al (1995) Brachytherapy in the combined modality treatment of pediatric malignancies. Principles and preliminary experience with treatment of soft tissue sarcoma (recurrence) and Ewing’s sarcoma. Klin Padiatr 207(4):164–173

    Article  PubMed  Google Scholar 

  65. Martelli H, Haie-Meder C, Branchereau S et al (2009) Conservative surgery plus brachytherapy treatment for boys with prostate and/or bladder neck rhabdomyosarcoma: a single team experience. J Pediatr Surg 44(1):190–196. doi:10.1016/j.jpedsurg.2008.10.040

    Article  PubMed  Google Scholar 

  66. Viani GA, Novaes PE, Jacinto AA et al (2008) High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience. Radiat Oncol 3:9. doi:10.1186/1748-717X-3-9

    Article  PubMed  PubMed Central  Google Scholar 

  67. Folkert MR, Tong WY, LaQuaglia MP et al (2014) 20-year experience with intraoperative high-dose-rate brachytherapy for pediatric sarcoma: outcomes, toxicity, and practice recommendations. Int Radiat Oncol Biol Phys 90(2):362–368. doi:10.1016/j.ijrobp.2014.06.016

    Article  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Susan King for her assistance in the editing and preparation of this chapter.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James Fontanesi MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Fontanesi, J., Mott, M., Margolis, J., Monit, G., Gerbaulet, A. (2016). Soft Tissue Sarcoma Brachytherapy. In: Montemaggi, P., Trombetta, M., Brady, L. (eds) Brachytherapy. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-319-26791-3_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26791-3_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26789-0

  • Online ISBN: 978-3-319-26791-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics