Interstitial radiotherapy using iridium 192 wires in the management of soft tissue sarcomas

Eighteen patients with a soft tissue sarcoma were treated between March 1984 and January 1989 by conservative surgical excision and interstitial implant using iridium 192 wires, associated in three patients with external radiation therapy and in eight with external radiation therapy and chemotherapy. One patient who developed local recurrence 34 months later underwent arm amputation and is alive and well 45 months following initial treatment. Three patients developed lung metastasis 6, 17 and 24 months later and died 12, 22 and 53 months respectively after initial treatment. Five patients (27.7%) developed a local radiation necrosis 6 to 19 months following the implant and four required surgical rehabilitation. Overall survival rate was 88% at 4 years and disease-free survival rate was 75% at 4 years. Considerations regarding local treatment of soft tissue sarcoma are discussed in this paper.