{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:24:06Z","timestamp":1788326646441,"version":"build-2803163510"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radiation is an integral part of treatment of soft tissue sarcoma. Interstitial brachytherapy (ISBT) can deliver boost or radical dose sparing critical structures. Although this technology has been around the longest, it is seldom found in recent literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To report the outcomes of patients with soft tissue sarcoma who underwent ISBT after surgical resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      We studied ISBT of extremity sarcoma in 60 patients aged between 3 and 77 years with a median age of 45 years and six patients belonging to the pediatric age group. Forty-two patients were males and 18 patients were females. Most common location was the thigh region (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 27). The most common histological pattern was synovial sarcoma (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20), followed by extra-skeletal osteosarcoma [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10]. Utmost caution was taken to minimize the skin dose and the complications of ISBT. All patients underwent intraoperative brachytherapy catheter implantation. Brachytherapy consisted of high-dose rate (HDR) Iridium-192 interstitial implant with a range from 3 to 6 Gy per fraction with total dose ranging from 45 to 50 Gy. Fifty-five percent had combined external-beam radiation therapy (EBRT) and ISBT ranging between 4 and 10 sessions of ISBT. Maximum follow-up period was 72 months. The average depth of insertion of the implant was 5 mm below the skin. The patients were serially followed up and wound condition, skin toxicity, recurrence, and functional status of the limb were documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At final follow-up, there was 91% local control (55 patients) on the study population that received ISBT. All the surviving patients had functional limb. Three patients died due to chemotherapy-related neutropenic sepsis and disease progression. Most common complication encountered was skin problems. Fourteen patients had local irritation which gradually subsided; four patients had wound breakdown which was treated by debridement and secondary closure for two and by flap cover for other two patients. Overall survival rate was 86.4% with a median follow-up period of 33 months (2.75 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Excellent local control and long-term survival with acceptable skin toxicities and wound complications were observed in our case series of patients treated with ISBT and ISBT + EBRT using an Iridium 192-based HDR system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_796_23","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:01:44Z","timestamp":1773046904000},"page":"535-540","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of interstitial brachytherapy in extremity sarcoma\u2014treatment outcomes and current concepts"],"prefix":"10.4103","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2525-5686","authenticated-orcid":false,"given":"Amar","family":"Kamat","sequence":"first","affiliation":[{"name":"Department of Musculoskeletal Oncology, Healthcare Global, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8801-2986","authenticated-orcid":false,"given":"Anto","family":"Gopurathingal","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Oncology, Healthcare Global, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7233-7428","authenticated-orcid":false,"given":"Pramod S.","family":"Chinder","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Oncology, Healthcare Global, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3847-3212","authenticated-orcid":false,"given":"Suraj","family":"Hindiskere","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Oncology, Healthcare Global, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4765-3578","authenticated-orcid":false,"given":"MS","family":"Belliappa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Healthcare Global, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"R1-20260309","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1002\/1097-0142(19900801)66:3<451::AID-CNCR2820660309>3.0.CO;2-J","article-title":"Soft tissue sarcoma integration of brachytherapy, resection, and external irradiation","volume":"66","author":"Schray","year":"1990","journal-title":"Cancer"},{"key":"R2-20260309","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1002\/1097-0142(19930815)72:4<1230::AID-CNCR2820720416>3.0.CO;2-J","article-title":"Limb-preserving treatment for soft tissue sarcomas of the extremities. The significance of surgical margins","volume":"72","author":"Herbert","year":"1993","journal-title":"Cancer"},{"key":"R3-20260309","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1097\/00000658-198209000-00009","article-title":"The treatment of soft-tissue sarcomas of the extremities: Prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy","volume":"196","author":"Rosenberg","year":"1982","journal-title":"Ann Surg"},{"key":"R4-20260309","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/00000658-199402000-00008","article-title":"Prognostic factors predictive of survival and local recurrence for extremity soft tissue sarcoma","volume":"219","author":"Singer","year":"1994","journal-title":"Ann Surg"},{"key":"R5-20260309","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/0360-3016(91)90074-E","article-title":"Local recurrence of soft tissue sarcoma following brachytherapy","volume":"20","author":"Gemer","year":"1991","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R7-20260309","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0360-3016(96)00331-8","article-title":"The effect of combined external beam radiotherapy and brachytherapy on local control and wound complications in patients with high-grade soft tissue sarcomas of the extremity with positive microscopic margin","volume":"36","author":"Alekhteyar","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R8-20260309","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1001\/archsurg.1987.01400230075014","article-title":"Local recurrence in adult soft tissue sarcoma: A randomized trial of brachytherapy","volume":"122","author":"Brennan","year":"1987","journal-title":"Arch Surg"},{"key":"R9-20260309","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/0360-3016(90)90012-9","article-title":"Limb salvage in soft tissue sarcomas involving neurovascular structures using combined surgical resection and brachytherapy","volume":"19","author":"Zelefsky","year":"1990","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Indian Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_796_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:20:53Z","timestamp":1787836853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_796_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijc.ijc_796_23","relation":{},"ISSN":["0019-509X","1998-4774"],"issn-type":[{"value":"0019-509X","type":"print"},{"value":"1998-4774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2023-09-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}