LAUSR

Definitive surgical resection is an integral component of curative intent management for localized soft tissue sarcoma, and margin status is a strong predictor for recurrence. Because of the large size and intimate association of retroperitoneal soft tissue sarcoma with vital normal structures at presentation, microscopically positive margins are common after curative intent interventions. This reality has driven clinical interest in the incorporation of radiation therapy (RT) in the intraoperative context, and several series have demonstrated promising rates of local control using intraoperative electron beam RT (IOERT). Similar principles may apply to the radical treatment of abdominal malignancies with soft tissue invasion. IOERT has been used for the treatment of locally advanced and recurrent colon cancer with promising rates of local control. Recently, an innovative, unidirectional, Pd-103 lowdose-rate brachytherapy device, CivaSheet (CivaTech, Durham, NC), has been developed for clinical use as an intraoperative RT (IORT) alternative. Here we present our initial clinical experience with the first 2 cases using this new IORT technology to boost the tumor bed after preoperative RT, including device implantation at time of tumor resection and evaluation of its positional stability with postimplant computed tomography (CT) studies.