Article
The additive value of intraoperative brachytherapy in the treatment of extremity leiomyosarcoma
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Authors
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Dietmar Dammerer
- Universitätsklinikum Krems, Abt. Orthopädie und Traumatologie, Krems an der Donau, Austria
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Annelies van Beeck
- University Hosptial Antwerp, Edegem, Belgium
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Katrin Wabro
- Medical University of Innsbruck, Dept. of Orthopaedics and Traumatology, Innsbruck, Austria
| Published: | October 25, 2022 |
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Outline
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Objectives: Leiomyosarcomas account for 8-10% of all extremity soft tissue sarcomas. Their treatment remains a challenge. The golden standard treatment at this moment consists of surgical excision combined with (neo)adjuvant radiotherapy. The place of brachytherapy as an additive booster therapy in the treatment of leiomyosarcomas is currently not clearly defined. This retrospective study focussed on the additive value of brachytherapy in the treatment of leiomyosarcomas.
Methods: This multicenter study compared treatment outcomes of 94 patients who were diagnosed with a primary leiomyosarcoma in their extremities. Patients were divided in three groups according to their radiotherapy protocol; adjuvant radiotherapy, neoadjuvant radiotherapy, and brachytherapy combined with adjuvant radiotherapy. These three treatment groups were compared for local control, time to metastasis and overall survival.
Results: Eleven patients were treated with intraoperative brachytherapy combined with adjuvant radiotherapy, 35 patients were treated with adjuvant radiotherapy alone, and seven patients were treated with neoadjuvant radiotherapy alone. The survival rate for patients treated with brachytherapy was 63.6%, for patients treated with adjuvant radiotherapy alone 48.6%, and for patients treated with neoadjuvant radiotherapy alone 71.4%. However, no significant differences were observed between these treatment groups concerning overall survival, local recurrence, or metastasis.
Conclusion: This study showed that additive brachytherapy did not provide an advantage in the treatment of leiomyosarcomas. No significant differences in treatment outcomes were observed between the three treatment groups. However, this study was limited by the amount of patients per treatment group. Larger international multicenter studies are necessary to objectivate the position of brachytherapy in the treatment of leiomyosarcomas.
