A Comparative Study of Soft Tissue Sarcomas of the Extremities; Brachytherapy versus Radiotherapy

Background: Soft tissue sarcoma (STS) is a wide group of solid tumors with specific features originating from mesenchymal tissue. Radiotherapy (RT) and chemotherapy have been widely applied in the treatment of these tumors to enhance surgical outcomes. This study was performed aiming to compare the results of postoperative brachytherapy (BRT) versus RT in patients who underwent surgical resection of extremity STSs. Methods: In a prospective study from 2011 to 2015, 166 patients with extremity STS who underwent surgical resection were included. All visible tumors, scars, and drain sites, if present during the surgery, were resected. A number of 79 patients received adjuvant RT, and 87 patients underwent BRT after surgical resection. Results: In patients who were treated through RT, the two-year local control was 90% in comparison with 87% for those treated through BRT (P > 0.050). The total radiation dose was 3869 ± 370 and 3048 ± 465 in the patients who underwent RT and in the BRT group (P < 0.001), respectively. The number of radiation sessions in the RT group and BRT group was respectively 27.3 ± 4.5 and 5.8 ± 2.0 (P = 0.001). Conclusion: Not only BRT can lead to similar local control and survival in comparison with the conventional adjuvant RT, but it can also decrease the total dose and number of radiation sessions in patients with STS of the extremity, which is a high grade, in individuals who underwent surgical resection.