Report of the First Patient Treated for Pelvic Sarcoma With a Directional 103Pd Brachytherapy Device

摘要

Sarcomas are rare malignant tumors of mesenchymalorigin with 80% originating from soft tissue.1 The majority of soft tissue sarcomas occur in the extremities;nevertheless, 10% to 15% occur in the retroperitoneum orpelvis and are usually advanced at time of diagnosis.2Oncologic resection with or without perioperative radiation therapy has become the cornerstone for successfultreatment.3-5 The goal of surgery is complete resection with negative margins (R0 resection). When not possible,either preoperative or postoperative radiation therapy isrecommended.6-9 Technical challenges related toanatomic complexities and large tumor size at diagnosisof most pelvic and retroperitoneal sarcomas often lead tomicroscopically positive margins (R1 resection) associated with high risk of local recurrence.2,10-13 Deliveringadequate doses of radiation in the postoperative settingrepresents a significant treatment challenge, especially insoft tissue sarcomas located in the abdomen, retroperitoneum, or pelvic regions.14 In these cases, localcontrol with preoperative and intraoperative radiationtherapy (IORT) are important considerations.