Cargando…

Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement

BACKGROUND: When a soft tissue sarcoma (STS) is located at the distal part of an extremity and involves the tendon, a wide excision usually causes severe functional disability. We therefore developed a minimally invasive surgical technique using intraoperative electron-beam radiotherapy (IOERT) to r...

Descripción completa

Detalles Bibliográficos
Autores principales: Matsumine, Akihiko, Tsujii, Masaya, Nakamura, Tomoki, Asanuma, Kunihiro, Matsubara, Takao, Kakimoto, Takuya, Yada, Yuki, Takada, Akinori, Ii, Noriko, Nomoto, Yoshihito, Sudo, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982423/
https://www.ncbi.nlm.nih.gov/pubmed/27514518
http://dx.doi.org/10.1186/s12957-016-0968-4
_version_ 1782447778991964160
author Matsumine, Akihiko
Tsujii, Masaya
Nakamura, Tomoki
Asanuma, Kunihiro
Matsubara, Takao
Kakimoto, Takuya
Yada, Yuki
Takada, Akinori
Ii, Noriko
Nomoto, Yoshihito
Sudo, Akihiro
author_facet Matsumine, Akihiko
Tsujii, Masaya
Nakamura, Tomoki
Asanuma, Kunihiro
Matsubara, Takao
Kakimoto, Takuya
Yada, Yuki
Takada, Akinori
Ii, Noriko
Nomoto, Yoshihito
Sudo, Akihiro
author_sort Matsumine, Akihiko
collection PubMed
description BACKGROUND: When a soft tissue sarcoma (STS) is located at the distal part of an extremity and involves the tendon, a wide excision usually causes severe functional disability. We therefore developed a minimally invasive surgical technique using intraoperative electron-beam radiotherapy (IOERT) to reduce the incidence of post-operative functional disability in patients with peri-/intra-tendinous STS. We assessed the clinical outcomes of the novel minimally invasive surgery. METHODS: The study population included five patients who received treatment for distal extremity STSs. After elevating the tumor mass, including the tendon and nerve from the tumor bed with a wide margin, a lead board was inserted beneath the tumor mass to shield the normal tissue. IOERT (25–50 Gy) was then applied, and the tumor excised with care taken to maintain the continuity of the tendon. RESULTS: In a desmoid patient, local recurrence was observed outside the irradiated field. No cases of neuropathy or bone necrosis were observed. The mean limb function score was excellent in all patients. None of the high-grade sarcoma patients had local recurrence or distant metastasis. CONCLUSIONS: Although the current study is only a pilot study with a small number of patients, it shows that this minimally invasive procedure has the potential to become a standard treatment option for selected patients. TRIAL REGISTRATION: H17-250 (registered 2 November 2005) and H25-250 (modified from H17-250, registered 5 December 2013)
format Online
Article
Text
id pubmed-4982423
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-49824232016-08-13 Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement Matsumine, Akihiko Tsujii, Masaya Nakamura, Tomoki Asanuma, Kunihiro Matsubara, Takao Kakimoto, Takuya Yada, Yuki Takada, Akinori Ii, Noriko Nomoto, Yoshihito Sudo, Akihiro World J Surg Oncol Research BACKGROUND: When a soft tissue sarcoma (STS) is located at the distal part of an extremity and involves the tendon, a wide excision usually causes severe functional disability. We therefore developed a minimally invasive surgical technique using intraoperative electron-beam radiotherapy (IOERT) to reduce the incidence of post-operative functional disability in patients with peri-/intra-tendinous STS. We assessed the clinical outcomes of the novel minimally invasive surgery. METHODS: The study population included five patients who received treatment for distal extremity STSs. After elevating the tumor mass, including the tendon and nerve from the tumor bed with a wide margin, a lead board was inserted beneath the tumor mass to shield the normal tissue. IOERT (25–50 Gy) was then applied, and the tumor excised with care taken to maintain the continuity of the tendon. RESULTS: In a desmoid patient, local recurrence was observed outside the irradiated field. No cases of neuropathy or bone necrosis were observed. The mean limb function score was excellent in all patients. None of the high-grade sarcoma patients had local recurrence or distant metastasis. CONCLUSIONS: Although the current study is only a pilot study with a small number of patients, it shows that this minimally invasive procedure has the potential to become a standard treatment option for selected patients. TRIAL REGISTRATION: H17-250 (registered 2 November 2005) and H25-250 (modified from H17-250, registered 5 December 2013) BioMed Central 2016-08-12 /pmc/articles/PMC4982423/ /pubmed/27514518 http://dx.doi.org/10.1186/s12957-016-0968-4 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Matsumine, Akihiko
Tsujii, Masaya
Nakamura, Tomoki
Asanuma, Kunihiro
Matsubara, Takao
Kakimoto, Takuya
Yada, Yuki
Takada, Akinori
Ii, Noriko
Nomoto, Yoshihito
Sudo, Akihiro
Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title_full Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title_fullStr Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title_full_unstemmed Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title_short Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
title_sort minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982423/
https://www.ncbi.nlm.nih.gov/pubmed/27514518
http://dx.doi.org/10.1186/s12957-016-0968-4
work_keys_str_mv AT matsumineakihiko minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT tsujiimasaya minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT nakamuratomoki minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT asanumakunihiro minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT matsubaratakao minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT kakimototakuya minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT yadayuki minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT takadaakinori minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT iinoriko minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT nomotoyoshihito minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement
AT sudoakihiro minimallyinvasivesurgeryusingintraoperativeelectronbeamradiotherapyforthetreatmentofsofttissuesarcomaoftheextremitieswithtendoninvolvement