Effect of Surgical Excision Combined with Brachytherapy Treatment on Sarcoma Surrounding Important Nerve and Blood Vessels

Abstract

Objective To analyze the efficacy and safety of surgical excision combined with brachytherapy treatment on sarcoma surrounding important nerve and blood vessels. Methods We retrospectively analyzed 30 patients pathologically diagnosed as sarcoma which was adjacent to the important nerve and blood vessels from March 2015 to April 2017. Extensive resection was performed. All patients received brachytherapy 2-3 days after operation. The fractional dose was 4Gy. The total dose of radiotherapy was 40Gy, twice a day. Brachytherapy took 5 days. All patients were assessed with MSTS function before surgery and 6 months after treatment. Results The follow-up time was 18-43 months, with an average of 31.6 months. The median follow-up time was 32.0 months. The 2-year survival rate was 96.7%, 18 cases(60%) of surgical margin R0 and 12 cases(40%) of R1. The MSTS score was 23.36±1.51 before operation and 21.51±1.82 six months after operation(P > 0.05). The local control rate of tumors was 93.3%. One patient died and one patient had nonunion incision. The incidence of ≥ grade 2 radiotherapy complications was 16.7%. Conclusion Surgical excision combined with brachytherapy treatment on sarcoma surrounding important nerve and blood vessels could achieve high local control rate, preserve limbs and have little influence on limb function of patients, but it is necessary to actively prevent and control the complications associated with brachytherapy.

Keywords

• sarcoma
• surgery
• brachytherapy