Background: When a soft tissue sarcoma (STS) is located at the distal part of an extremity and involves the tendon,\na wide excision usually causes severe functional disability. We therefore developed a minimally invasive surgical\ntechnique using intraoperative electron-beam radiotherapy (IOERT) to reduce the incidence of post-operative\nfunctional disability in patients with peri-/intra-tendinous STS. We assessed the clinical outcomes of the novel\nminimally invasive surgery.\nMethods: The study population included five patients who received treatment for distal extremity STSs. After\nelevating the tumor mass, including the tendon and nerve from the tumor bed with a wide margin, a lead board\nwas inserted beneath the tumor mass to shield the normal tissue. IOERT (25ââ?¬â??50 Gy) was then applied, and the\ntumor excised with care taken to maintain the continuity of the tendon.\nResults: In a desmoid patient, local recurrence was observed outside the irradiated field. No cases of neuropathy or\nbone necrosis were observed. The mean limb function score was excellent in all patients. None of the high-grade\nsarcoma patients had local recurrence or distant metastasis.\nConclusions: Although the current study is only a pilot study with a small number of patients, it shows that this\nminimally invasive procedure has the potential to become a standard treatment option for selected patients.
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