Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas
The purpose of this study was to analyze the results of treatment of retroperitoneal soft tissue sarcomas (RSTS) by surgery combined with intraoperative brachytherapy (IOBRT). Seventy adult patients with RSTS were considered for combined treatment (surgery plus IOBRT) between June 1998 and February...
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| Veröffentlicht in: | Annals of surgical oncology 2006-02, Vol.13 (2), p.245-252 |
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| creator | Dziewirski, Wirginiusz Rutkowski, Piotr Nowecki, Zbigniew I Sałamacha, Maciej Morysiński, Tadeusz Kulik, Anna Kawczyńska, Maria Kasprowicz, Anetta Lyczek, Jarosław Ruka, Włodzimierz |
| description | The purpose of this study was to analyze the results of treatment of retroperitoneal soft tissue sarcomas (RSTS) by surgery combined with intraoperative brachytherapy (IOBRT).
Seventy adult patients with RSTS were considered for combined treatment (surgery plus IOBRT) between June 1998 and February 2004. There were 64 (91%) recurrent tumors, and 93% of tumors exceeded 5 cm. IOBRT was performed with high-dose-rate Gammamed 12 with iridium 192 (IOBRT time range, 20-87 minutes; median, 56 minutes).
After intraoperative re-evaluation, 24 patients (34%) were found to be ineligible for IOBRT because of multiple intraperitoneal recurrences, macroscopically nonradical resection, poor general condition, and technical aspects. Thirty-seven patients underwent IOBRT immediately after surgery during the same general anesthesia procedure. Nine patients underwent delayed IOBRT within 1 to 3 days after the primary operation. Ten (21.5%) of 46 patients underwent reoperation because of surgical complications. One patient died in the postoperative period. After IOBRT, 24 patients (52%) underwent adjuvant external beam radiotherapy (EBRT) to a total dose of 50 Gy. Over a median follow-up time of 20 months, the estimated 5-year overall survival and local recurrence-free survival rates in IOBRT patients were 55% and 51%, respectively. Application of adjuvant EBRT showed a favorable local control rate.
The scheduled combined treatment (surgery plus IOBRT) was possible to perform in 66% of RSTS cases that received surgical treatment. The complication rate was high, but we consider it acceptable because of the necessity for extensive aggressive surgical treatment in regionally advanced RSTS. EBRT seems to be an indispensable part of treatment that provides better local control. |
| doi_str_mv | 10.1245/ASO.2006.03.026 |
| format | Article |
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Seventy adult patients with RSTS were considered for combined treatment (surgery plus IOBRT) between June 1998 and February 2004. There were 64 (91%) recurrent tumors, and 93% of tumors exceeded 5 cm. IOBRT was performed with high-dose-rate Gammamed 12 with iridium 192 (IOBRT time range, 20-87 minutes; median, 56 minutes).
After intraoperative re-evaluation, 24 patients (34%) were found to be ineligible for IOBRT because of multiple intraperitoneal recurrences, macroscopically nonradical resection, poor general condition, and technical aspects. Thirty-seven patients underwent IOBRT immediately after surgery during the same general anesthesia procedure. Nine patients underwent delayed IOBRT within 1 to 3 days after the primary operation. Ten (21.5%) of 46 patients underwent reoperation because of surgical complications. One patient died in the postoperative period. After IOBRT, 24 patients (52%) underwent adjuvant external beam radiotherapy (EBRT) to a total dose of 50 Gy. Over a median follow-up time of 20 months, the estimated 5-year overall survival and local recurrence-free survival rates in IOBRT patients were 55% and 51%, respectively. Application of adjuvant EBRT showed a favorable local control rate.
The scheduled combined treatment (surgery plus IOBRT) was possible to perform in 66% of RSTS cases that received surgical treatment. The complication rate was high, but we consider it acceptable because of the necessity for extensive aggressive surgical treatment in regionally advanced RSTS. EBRT seems to be an indispensable part of treatment that provides better local control.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/ASO.2006.03.026</identifier><identifier>PMID: 16411144</identifier><language>eng</language><publisher>United States: Springer Nature B.V</publisher><subject>Adolescent ; Adult ; Aged ; Brachytherapy ; Combined Modality Therapy ; Female ; Humans ; Intraoperative Care ; Male ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - radiotherapy ; Neoplasm Recurrence, Local - surgery ; Poland - epidemiology ; Prognosis ; Radiotherapy Dosage ; Retroperitoneal Neoplasms - mortality ; Retroperitoneal Neoplasms - pathology ; Retroperitoneal Neoplasms - radiotherapy ; Retroperitoneal Neoplasms - surgery ; Sarcoma - mortality ; Sarcoma - pathology ; Sarcoma - radiotherapy ; Sarcoma - surgery ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2006-02, Vol.13 (2), p.245-252</ispartof><rights>The Society of Surgical Oncology, Inc. 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c322t-ce854b2a90b8612efd04f674c5052f9b8b48becc2fd0c78f81afc3de5524d54a3</citedby><cites>FETCH-LOGICAL-c322t-ce854b2a90b8612efd04f674c5052f9b8b48becc2fd0c78f81afc3de5524d54a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16411144$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dziewirski, Wirginiusz</creatorcontrib><creatorcontrib>Rutkowski, Piotr</creatorcontrib><creatorcontrib>Nowecki, Zbigniew I</creatorcontrib><creatorcontrib>Sałamacha, Maciej</creatorcontrib><creatorcontrib>Morysiński, Tadeusz</creatorcontrib><creatorcontrib>Kulik, Anna</creatorcontrib><creatorcontrib>Kawczyńska, Maria</creatorcontrib><creatorcontrib>Kasprowicz, Anetta</creatorcontrib><creatorcontrib>Lyczek, Jarosław</creatorcontrib><creatorcontrib>Ruka, Włodzimierz</creatorcontrib><title>Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><description>The purpose of this study was to analyze the results of treatment of retroperitoneal soft tissue sarcomas (RSTS) by surgery combined with intraoperative brachytherapy (IOBRT).
Seventy adult patients with RSTS were considered for combined treatment (surgery plus IOBRT) between June 1998 and February 2004. There were 64 (91%) recurrent tumors, and 93% of tumors exceeded 5 cm. IOBRT was performed with high-dose-rate Gammamed 12 with iridium 192 (IOBRT time range, 20-87 minutes; median, 56 minutes).
After intraoperative re-evaluation, 24 patients (34%) were found to be ineligible for IOBRT because of multiple intraperitoneal recurrences, macroscopically nonradical resection, poor general condition, and technical aspects. Thirty-seven patients underwent IOBRT immediately after surgery during the same general anesthesia procedure. Nine patients underwent delayed IOBRT within 1 to 3 days after the primary operation. Ten (21.5%) of 46 patients underwent reoperation because of surgical complications. One patient died in the postoperative period. After IOBRT, 24 patients (52%) underwent adjuvant external beam radiotherapy (EBRT) to a total dose of 50 Gy. Over a median follow-up time of 20 months, the estimated 5-year overall survival and local recurrence-free survival rates in IOBRT patients were 55% and 51%, respectively. Application of adjuvant EBRT showed a favorable local control rate.
The scheduled combined treatment (surgery plus IOBRT) was possible to perform in 66% of RSTS cases that received surgical treatment. The complication rate was high, but we consider it acceptable because of the necessity for extensive aggressive surgical treatment in regionally advanced RSTS. EBRT seems to be an indispensable part of treatment that provides better local control.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Brachytherapy</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Care</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - radiotherapy</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Poland - epidemiology</subject><subject>Prognosis</subject><subject>Radiotherapy Dosage</subject><subject>Retroperitoneal Neoplasms - mortality</subject><subject>Retroperitoneal Neoplasms - pathology</subject><subject>Retroperitoneal Neoplasms - radiotherapy</subject><subject>Retroperitoneal Neoplasms - surgery</subject><subject>Sarcoma - mortality</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - radiotherapy</subject><subject>Sarcoma - surgery</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkE1LAzEQhoMoVqtnbxI8eNs235seS_ELCj1UzyGbnbVburs1ySr7701pQfA0M8wzL8OD0B0lE8qEnM7XqwkjRE0InxCmztAVlVxkQml6nnqidDZjSo7QdQhbQmjOibxEI6oEpVSIK2TWvf8EP2DXNUXdQol_6rjBdRu97fbgbay_ARfeus0QN2neD2mJU4ujBxsbaCPuKuwh-gNfx64Fu8PB-pRoww26qOwuwO2pjtHH89P74jVbrl7eFvNl5jhjMXOgpSiYnZFCK8qgKomoVC6cJJJVs0IXQhfgHEsLl-tKU1s5XoKUTJRSWD5Gj8fcve--egjRNHVwsNvZFro-mJzkhCquE_jwD9x2vW_Tb4axnCtJ-SxB0yPkfBeCh8rsfd1YPxhKzEG8SeLNQbwh3CTx6eL-FNsXDZR__Mk0_wWXDIA_</recordid><startdate>200602</startdate><enddate>200602</enddate><creator>Dziewirski, Wirginiusz</creator><creator>Rutkowski, Piotr</creator><creator>Nowecki, Zbigniew I</creator><creator>Sałamacha, Maciej</creator><creator>Morysiński, Tadeusz</creator><creator>Kulik, Anna</creator><creator>Kawczyńska, Maria</creator><creator>Kasprowicz, Anetta</creator><creator>Lyczek, Jarosław</creator><creator>Ruka, Włodzimierz</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200602</creationdate><title>Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas</title><author>Dziewirski, Wirginiusz ; Rutkowski, Piotr ; Nowecki, Zbigniew I ; Sałamacha, Maciej ; Morysiński, Tadeusz ; Kulik, Anna ; Kawczyńska, Maria ; Kasprowicz, Anetta ; Lyczek, Jarosław ; Ruka, Włodzimierz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c322t-ce854b2a90b8612efd04f674c5052f9b8b48becc2fd0c78f81afc3de5524d54a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Brachytherapy</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Care</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - radiotherapy</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Poland - epidemiology</topic><topic>Prognosis</topic><topic>Radiotherapy Dosage</topic><topic>Retroperitoneal Neoplasms - mortality</topic><topic>Retroperitoneal Neoplasms - pathology</topic><topic>Retroperitoneal Neoplasms - radiotherapy</topic><topic>Retroperitoneal Neoplasms - surgery</topic><topic>Sarcoma - mortality</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - radiotherapy</topic><topic>Sarcoma - surgery</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dziewirski, Wirginiusz</creatorcontrib><creatorcontrib>Rutkowski, Piotr</creatorcontrib><creatorcontrib>Nowecki, Zbigniew I</creatorcontrib><creatorcontrib>Sałamacha, Maciej</creatorcontrib><creatorcontrib>Morysiński, Tadeusz</creatorcontrib><creatorcontrib>Kulik, Anna</creatorcontrib><creatorcontrib>Kawczyńska, Maria</creatorcontrib><creatorcontrib>Kasprowicz, Anetta</creatorcontrib><creatorcontrib>Lyczek, Jarosław</creatorcontrib><creatorcontrib>Ruka, Włodzimierz</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dziewirski, Wirginiusz</au><au>Rutkowski, Piotr</au><au>Nowecki, Zbigniew I</au><au>Sałamacha, Maciej</au><au>Morysiński, Tadeusz</au><au>Kulik, Anna</au><au>Kawczyńska, Maria</au><au>Kasprowicz, Anetta</au><au>Lyczek, Jarosław</au><au>Ruka, Włodzimierz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas</atitle><jtitle>Annals of surgical oncology</jtitle><addtitle>Ann Surg Oncol</addtitle><date>2006-02</date><risdate>2006</risdate><volume>13</volume><issue>2</issue><spage>245</spage><epage>252</epage><pages>245-252</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>The purpose of this study was to analyze the results of treatment of retroperitoneal soft tissue sarcomas (RSTS) by surgery combined with intraoperative brachytherapy (IOBRT).
Seventy adult patients with RSTS were considered for combined treatment (surgery plus IOBRT) between June 1998 and February 2004. There were 64 (91%) recurrent tumors, and 93% of tumors exceeded 5 cm. IOBRT was performed with high-dose-rate Gammamed 12 with iridium 192 (IOBRT time range, 20-87 minutes; median, 56 minutes).
After intraoperative re-evaluation, 24 patients (34%) were found to be ineligible for IOBRT because of multiple intraperitoneal recurrences, macroscopically nonradical resection, poor general condition, and technical aspects. Thirty-seven patients underwent IOBRT immediately after surgery during the same general anesthesia procedure. Nine patients underwent delayed IOBRT within 1 to 3 days after the primary operation. Ten (21.5%) of 46 patients underwent reoperation because of surgical complications. One patient died in the postoperative period. After IOBRT, 24 patients (52%) underwent adjuvant external beam radiotherapy (EBRT) to a total dose of 50 Gy. Over a median follow-up time of 20 months, the estimated 5-year overall survival and local recurrence-free survival rates in IOBRT patients were 55% and 51%, respectively. Application of adjuvant EBRT showed a favorable local control rate.
The scheduled combined treatment (surgery plus IOBRT) was possible to perform in 66% of RSTS cases that received surgical treatment. The complication rate was high, but we consider it acceptable because of the necessity for extensive aggressive surgical treatment in regionally advanced RSTS. EBRT seems to be an indispensable part of treatment that provides better local control.</abstract><cop>United States</cop><pub>Springer Nature B.V</pub><pmid>16411144</pmid><doi>10.1245/ASO.2006.03.026</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Brachytherapy Combined Modality Therapy Female Humans Intraoperative Care Male Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - radiotherapy Neoplasm Recurrence, Local - surgery Poland - epidemiology Prognosis Radiotherapy Dosage Retroperitoneal Neoplasms - mortality Retroperitoneal Neoplasms - pathology Retroperitoneal Neoplasms - radiotherapy Retroperitoneal Neoplasms - surgery Sarcoma - mortality Sarcoma - pathology Sarcoma - radiotherapy Sarcoma - surgery Survival Rate |
| title | Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas |
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