Intraoperative radiotherapy for extremity soft-tissue sarcomas: can long-term local control be achieved?

Abstract

IOERT used as a boost to EBRT provides high local control and limb-sparing rates in patients with STS of the extremities, with less toxicity than EBRT alone.

Long‐term experience with intraoperative electron radiation therapy boost in extremity sarcoma

“…Our experience matches other series in terms of low severe toxicity rates. Across the many IOERT experiences, Grade 3 late toxicity ranged from 10%–31% 12,13,21–24,30–35 . In our series, we demonstrated low Grade 3 late toxicity; fracture requiring surgical fixation occurred within 7 (6%) patients and severe neuropathy occurred in only 1 (1%) patient within our cohort.…”

“…Across the many IOERT experiences, Grade 3 late toxicity ranged from 10%-31%. 12,13,[21][22][23][24][30][31][32][33][34][35] In our series, we demonstrated low Grade 3 late toxicity; fracture requiring surgical fixation occurred within 7 (6%) patients and severe neuropathy occurred in only 1 (1%) patient within our cohort. However, there were 11 (10%) patients who had 21 The same group reported data on 50 patients in a prospective trial, which shows an 18% late severe toxicity rate in addition to excellent control rates.…”

“…The supporting evidence for the use of IOERT is based primarily on retrospective single‐center studies, although there are few small prospective trials. The combination of EBRT, IOERT, and LSS has resulted in 5‐year LC of 82‐97% and limb perseveration ranging of 81%–100% and functional outcome of 59%–100% 12–14,21–24 . In the largest retrospective study of 183 cases using LSS, IOERT, and pre‐ or postoperative EBRT, Roeder et al reported 5‐ and 10‐ year LC to be 86% and 84%, respectively 21 .…”

“…The combination of EBRT, IOERT, and LSS has resulted in 5-year LC of 82-97% and limb perseveration ranging of 81%-100% and functional outcome of 59%-100%. [12][13][14][21][22][23][24] In the largest retrospective study of 183 cases using LSS, IOERT, and pre-or postoperative EBRT, Roeder et al…”

Intraoperative radiation therapy in non-breast cancer patients: A report of 26 cases from Shiraz, south of Iran

“…While 50% of patients with involved margins had local recurrence, only 7% of those with negative margins had recurrence. They concluded that local control was excellent, and side effects were acceptable (10). IORT provides an excellent chance to irradiate the tumor bed or residue and spare the sensitive tissues.…”