Perioperative High- dose Rate Brachytherapy Using a Bendy Applicator (Flab): Treatment Results of 74 Patients

Background:Radiotherapyplaysapivotalrolein tumor treatment. Brachytherapy as an additional radiation techniqueallowslocaldoseincrementsinareasathighrisk of local failure. Patients and Methods: Our past 15-year experience with tissue-equivalent bendy applicator brachytherapyattheUniversityHospitalMunster,Germany was reviewed.A series of 74 consecutive patients who had mainly been treated for sarcomas with perioperative brachytherapy was analyzed with a focus on local relapse- free survival and side-effects. Results: The 5-year local controlratewas73%inprimarytreatmentsituationswitha significant influence of additional external irradiation, surgical margin depth and tumor entity. Late sequelae of combined modality treatment were observed in 40 patients (54%)andmainlyconcernedwoundhealing(n=18,24%). Conclusion:A high-risk collective, in view of local failure, showed adequate local control rates as well as acceptable latesequelae.Flabbrachytherapyisagoodtreatmentoption toachievelocalradiationdoseincrementsinpatientsathigh riskoflocalfailure. The majority of solid malignant tumors are treated within a multimodal treatment approach comprised of surgery, chemotherapy and radiotherapy. Sufficient local therapy is very important in curative treatment, especially in sarcoma patients (1-3), and where only marginal resections can be performed. Multidisciplinary therapy, including adjuvant chemotherapy and pre- or postoperative radiotherapy, is particularly important (1, 4). In the context of organ and function preservation, external beam radiotherapy (EBRT) plays a pivotal role in the local control of tumors and is an integralcomponentofmosttreatmentprotocols.However,the