The role of
brachytherapy in the therapeutic strategy of
soft tissue sarcomas has been difficult to assess due to the fact it has been during a long time institution-specific. However, the experience gained specially with low dose-rate treatments has allowed formulating guidelines for technical rules and patient selection.
Brachytherapy used as an isolated treatment combined with surgery has proven to be effective in high-grade
sarcomas, compared to surgery alone, in a unique randomized trial. Beside, a number of data have shown that the combination of
brachytherapy and external beam irradiation could be superior to
brachytherapy or external beam irradiation alone in the treatment of
tumors with high-grade, or central location, locally advanced or on contact with neurovascular structures.
Brachytherapy alone, combined with surgery, is of interest for
conservative treatment of recurrent
sarcomas occurring in previously irradiated areas. The occurrence of side effects remains acceptable if technical guidelines are followed, for surgery as well as for
brachytherapy, using the most modern available treatment techniques.
Brachytherapy should be at the moment an integrated part of the multidisciplinary treatment of
soft tissue sarcomas.