Single-institution RCT of 164 patients with extremity or superficial trunk soft tissue sarcomas randomized intraoperatively to iridium-192 brachytherapy (42–45 Gy over 4–6 days) versus no adjuvant therapy after complete resection. Median follow-up 76 months. Asks whether adjuvant brachytherapy improves local control and whether any local control gain translates to survival benefit.
Adjuvant brachytherapy should be considered for high-grade soft tissue sarcomas to improve local control, though it won't affect survival or distant metastasis rates. The benefit is grade-dependent—don't expect improved local control in low-grade lesions.
Single-institution RCT of 164 patients with extremity or superficial trunk soft tissue sarcomas randomized intraoperatively to iridium-192 brachytherapy (42–45 Gy over 4–6 days) versus no adjuvant therapy after complete resection. Median follow-up 76 months. Asks whether adjuvant brachytherapy improves local control and whether any local control gain translates to survival benefit.
Adjuvant brachytherapy should be considered for high-grade soft tissue sarcomas to improve local control, though it won't affect survival or distant metastasis rates. The benefit is grade-dependent—don't expect improved local control in low-grade lesions.