Outcome of soft-tissue reconstruction in the setting of combined preoperative and intraoperative radiotherapy for extremity soft-tissue sarcomas

Rachel L. Honig, Meagan E. Tibbo, Katherine E. Mallett, Karim Bakri, Safia K. Ahmed, Ivy A. Petersen, Peter S. Rose, Steven L. Moran, Matthew T. Houdek

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aim: Reconstruction for soft-tissue sarcomas is complex and often uses soft-tissue flaps. To preserve critical structures, intraoperative radiotherapy (IORT) can be used to boost the total dose to these critical structures and close margins; however, there are limited data on the outcome of soft-tissue reconstruction in patients treated with IORT. Patients and Methods: Twenty patients received IORT with soft-tissue flap coverage. There were 14 tumors of the lower extremities and six of the upper, including seven free-flaps and 13 pedicle flaps. Mean preoperative and IORT doses were 49.4 Gy and 10.4 Gy, respectively, with a mean total dose of 59.8 Gy. Results: Seven (35%) patients had a complication, most commonly an infection (n=4, 27%). Total flap loss occurred in one treated with pedicle flap. Four (20%) patients suffered a radiation-associated fracture. At the final follow-up, the mean Musculoskeletal Tumor Society Score was 75±11%. Conclusion: Complications and postoperative fractures were common with IORT, however, there were no cases requiring amputation.

Original languageEnglish (US)
Pages (from-to)6941-6945
Number of pages5
JournalAnticancer research
Volume40
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Flap
  • IORT
  • Intraoperative radiotherapy
  • Limb salvage
  • Soft-tissue reconstruction

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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