Feasibility report of conservative surgery, perioperative high-dose-rate brachytherapy (PHDRB), and low-to-moderate dose external beam radiation therapy (EBRT) in pediatric sarcomas

Abstract

This study was undertaken to determine the feasibility of perioperative high-dose-rate brachytherapy (PHDRB) as an accelerated boost in patients with pediatric sarcomas. METHODS AND MATERIALS: Five pediatric patients (ages 7-16) with soft tissue sarcomas (STS) or soft tissue recurrences of previously treated osteosarcomas were treated with surgical resection and PHDRB (16-24 Gy) for R0-R1 resections. Patients with STS and osteosarcomas received 27 Gy and 45 Gy of EBRT postoperatively. RESULTS: After a median follow-up of 27 months (range, 12-50) all the patients remain locally controlled. Only 1 patient developed regrowth of pulmonary metastases and died of distant disease at 16 months. CONCLUSIONS: The use of PHDRB is safe in the short-term in this pediatric population. Only 1 patient suffered a partial wound dehiscence that may not be entirely related to PHDRB. Patients with recurrent osteosarcomas can be treated in a fashion similar to their adult soft tissue counterparts and avoid limb amputation. Younger patients with STS may achieve local control and prevent growth retardation with a combination of PHDRB and moderate doses of EBRT