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NCCN Guidelines for Patients

®

Soft Tissue Sarcoma, Version 1.2014

9

1

Sarcoma basics

Local treatments

beams, and number of treatment sessions. Beams

are shaped with computer software and hardware

added to the radiation machine. Radiation beams are

aimed at the tumor with help from ink marks on the

skin or marker seeds in the tumor.

During treatment, you will lie on a table in the same

position as you did for simulation. Devices may be

used to keep you from moving so that the radiation

targets the tumor in the same place every day of

treatment. You will be alone while the technician

operates the machine from a nearby room. He or she

will be able to see, hear, and speak with you at all

times. As treatment is given, you may hear noises.

There are multiple types of EBRT. For sarcoma,

3D-CRT (

three

-

d

imensional

c

onformal

r

adiation

t

herapy), IMRT (

i

ntensity-

m

odulated

r

adiation

t

herapy), or SBRT (

s

tereotactic

b

ody

r

adiation

t

herapy) may be used. In 3D-CRT, the radiation

beams match the shape of the tumor to avoid healthy

tissues. IMRT is a more precise type of 3D-CRT. The

radiation beam is divided into smaller beams, and the

strength of each beam can vary. 3D-CRT and IMRT

take several weeks to complete. SBRT is completed

in 1 to 2 weeks and treats sarcomas with precise but

high-dose beams.

3D-CRT and IMRT use photon radiation beams.

Photon beams are a stream of particles that have no

mass or electric charge. In recent years, a few cancer

centers have built radiation machines that use proton

beams. Proton beams are a stream of positively

charged particles that emit energy within a short

distance. SBRT uses either photons or protons.

Brachytherapy

Brachytherapy involves placing small radioactive

objects next to cancer cells. The objects are inserted

using small tubes (catheters) that were placed during

surgery. Brachytherapy can be given either as LDR

(

l

ow-

d

ose

r

ate) or HDR (

h

igh-

d

ose

r

ate).

For LDR brachytherapy, the radioactive objects will

remain in your body for a few days. The objects give

off low doses of radiation during the whole time the

objects are in you. The radiation travels a very short

distance.

HDR brachytherapy is a newer method. It gives more

radiation than LDR, but the radiation stays in your

body for a shorter period of time. Before treatment,

imaging will be done to assure the catheters are in

place. A machine will then pump, the radioactive

source into the catheters. After treatment, the

machine will remove the radioactive source from your

body. You may receive HDR more than once a day for

a short period of time. HRD brachytherapy can also

be used as IORT.

Ablation

Ablation destroys small tumors with little harm to

nearby tissue. There is more than one way to “ablate”

a tumor. Cryoablation kills cancer cells by freezing

them with liquid nitrogen. Radiofrequency ablation

kills cancer cells with high-energy radio waves. A

probe placed into the tumor emits the waves. The

probe will be guided into place by ultrasound or CT

(

c

omputed

t

omography) scans and will be removed

when treatment is done.

Embolization

Embolization treats tumors by cutting off their

blood supply. A catheter will be inserted into an

artery and guided to the tumor. Once in place,

beads will be inserted to block the blood flow.

With chemoembolization, the beads are coated

with chemotherapy. Radioembolization uses small

radioactive beads.