Role of perioperative brachytherapy in the treatment of malignancies involving the skull base and orbit

Neurosurgery Quarterly

Volumn 17, Issue 3, 2007, Pages 193-207

  Strege, Rainer Joachim ^a,b   Kovács, György ^a   Lamcke, Philip ^a   Maune, Steffen ^a   Holland, Detlef ^a   Eichmann, Thomas ^a   Maximilian Mehdorn, Hubertus ^a  

^a UNIVERSITY HOSPITAL SCHLESWIG HOLSTEIN   (Germany)

^b UNIVERSITY MEDICAL CENTER GÖTTINGEN   (Germany)

Author keywords

Intensity modulated brachytherapy (IMBT); Malignant orbital tumors; Malignant skull base tumors; Paranasal sinus carcinomas; Rhabdomyosarcomas; Skull base surgery

Indexed keywords

GOLD 198; IODINE 125; IRIDIUM 192; RADIUM 226; RADON 222;

BRACHYTHERAPY; ESTHESIONEUROBLASTOMA; EXPERIENCE; EXTERNAL BEAM RADIOTHERAPY; HEAD AND NECK CANCER; HUMAN; IMPLANT; MEDLINE; ORBIT TUMOR; PARANASAL SINUS CARCINOMA; POSTOPERATIVE CARE; PREOPERATIVE PERIOD; PRIORITY JOURNAL; RADIATION DOSE; RADIATION DOSE FRACTIONATION; RADIOISOTOPE THERAPY; REVIEW; RHABDOMYOSARCOMA; SKULL BASE TUMOR; SKULL SURGERY; SYSTEMATIC REVIEW;

EID: 34548134795     PISSN: 10506438     EISSN: None     Source Type: Journal    
DOI: 10.1097/WNQ.0b013e318149e2db     Document Type: Review

References (119)

1. Ahn YC, Lee KC, Kim DY, et al. Fractionated stereotactic radiation therapy for extracranial head and neck tumors. Int J Radiat Oncol Biol Phys. 2000;48:501-505.
2. Milanovic D, Lohr F, Götte K, et al. Intensity modulated radiotherapy (IMRT) of head and neck tumors. Increased biological effectiveness in high-risk situations by "integrated boost" therapy. HNO. 2004;52:729-736.
3. Schultz-Ertner D, Nikoghosyan A, Thilmann C, et al. Carbon ion radiotherapy for chordomas and low-grade chondrosarcomas of the skull base. Results in 67 patients. Strahlenther Onkol. 2003;179:598-605.
4. Habermann W, Zanarotti U, Groell R, et al. Combination of surgery and gamma knife radiosurgery - a therapeutic option for patients with tumors of nasal cavity or paranasal sinuses infiltrating the skull base. Acta Otorhinolaryngol Ital. 2002;22:74-79.
5. Strege RJ, Kovács G, Maune S, et al. Feasibility of combined operation and perioperative intensity-modulated brachytherapy of advanced/recurrent malignancies involving the skull base. Strahlenther Onkol. 2005;181:97-107.
6. Nakamura JL, Pirzkall A, Carol MP, et al. Comparison of intensity-modulated radiosurgery with gamma knife radiosurgery for challenging skull base lesions. Int J Radiat Oncol Biol Phys. 2003;55:99-109.
7. Hug EB, Adams J, Fitzek M, et al. Fractionated, three-dimensional, planning-assisted proton-radiation therapy for orbital rhabdomyosarcoma: a novel technique. Int J Radiat Oncol Biol Phys. 2000;47:979-984.
8. Gutin PH, Leibel SA, Hosobuchi Y, et al. Brachytherapy of recurrent tumors of the skull base and spine with Iodine-125 sources. Neurosurgery. 1987;20:938-945.
9. Kumar PP, Good RR, Leibrock LG, et al. High activity iodine 125 endocurietherapy for recurrent skull base tumors. Cancer. 1988;61:1518-1527.
10. Russel JD, Bleach NR, Glaser M, et al. Brachytherapy for recurrent nasopharyngeal and nasoethmoidal tumours. J Laryngol Otol. 1993;107:115-120.
11. Nag S, Schuller D, Pak V, et al. Pilot study of intraoperative high dose rate brachytherapy for head and neck caner. Radiother Oncol. 1996;41:125-130.
12. Abramson DH, Fass D, McCormick B, et al. Implant brachytherapy: a novel treatment for recurrent orbital rhabdomyosarcoma. JAAPOS. 1997;1:154-157.
13. Bacskulin A, Ehrhardt M, Strietzel M, et al. An adjuvant afterloading brachytherapy device for use after orbital exenteration in patients with orbital malignancies. Ger J Ophthalmol. 1996;5:484-488.
14. Kovács G, Rochels R, Mehdorn HM, et al. Eye preservation brachytherapy for orbital and adjacent tumors: preliminary results. In: Wiegel T, Bornfeld N, Foerster MH, eds. Radiotherapy of Ocular Disease. Front Radiat Ther Oncol. Vol 30. Basel: Karger; 1997:56-64.
15. Tyl JW, Blank LE, Koornneef L. Brachytherapy in orbital tumors. Ophthalmology. 1997;104:1475-1479.
16. Nag S, Schuller DE, Rodriguez-Villalba S, et al. Intraoperative high dose rate brachytherapy can be used to salvage patients with previously irradiated head and neck recurrences. Rev Med Univ Navarra. 1999;43:17-22.
17. Kumar PP, Patil AA. Interstitial brachytherapy for skull base tumors. Neurosurg Clin N Am. 2000;11:639-649.
18. Nag S, Tippin D, Grecula J, et al. Intraoperative high-dose-rate brachytherapy for paranasal sinus tumors. Int J Radiat Oncol Biol Phys. 2004;58:155-160.
19. Buwalda J, Freling NJ, Blank LECM, et al. AMORE protocol in pediatric head and neck rhabdomyosarcoma: a descriptive analysis of failure patterns. Head Neck. 2005;27:390-396.
20. Nag S, Koc M, Schuller D, et al. Intraoperative single fraction high-dose-rate brachytherapy for head and neck cancers. Brachytherapy. 2005;4:217-223.
21. Blank LECM, Gonzalez D, Koedooder C, et al. Brachytherapy in the treatment of orbital tumors. Proceedings, Annual GECESTRO Meeting, Venezia, May 12-15, 1992:50.
22. Buwalda J, Blank LE, Schouwenbourg PF, et al. The AMORE protocol as salvage treatment for non-orbital head and neck rhabdomyosarcoma in children. Eur J Surg Oncol. 2004;30:884-892.
23. Buwalda J, Schouwenburg PF, Blank LECM, et al. A novel local treatment strategy for advanced stage head and neck rhabdomyosarcomas in children: results of the AMORE protocol. Eur J Cancer. 2003;1594-1602.
24. Schouwenburg PF, Kupperman D, Bakker FP, et al. New combined treatment of surgery, radiotherapy, and reconstruction in head and neck rhabdomyosarcoma in children: the AMORE protocol. Head Neck. 1998;20:283-92.
25. Bernstein M, Gutin PH. Interstitial irradiation of skull base tumours. Can J Neurol Sci. 1985;12:366-370.
26. Kumar PP, Patil AA, Leibrock LG, et al. Brachytherapy: a viable alternative in the management of basal meningiomas. Neurosurgery. 1991;29:676-680.
27. Kumar PP, Patil AA, Syh H-W, et al. Role of brachytherapy in the management of the skull base meningioma. Treatment of skull base meningiomas. Cancer. 1993;71:3726-3731.
28. Nag S, Hu KS. Intraoperative high-dose-rate brachytherapy. Surg Oncol Clin N Am. 2003;12:1079-1097. Review.
29. Nag S, Tippin D, Ruymann FB. Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: the Ohio State University experience. Clin Invest. 2001;51:729-735.
30. Nag S, Fernandes PS, Martinez-Monge R, et al. Use of brachytherapy to preserve function in children with soft-tissue sarcomas. Oncology. 1999;13:361-369.
31. Levendag PC, Vikram B, Yin W, et al. High dose rate brachytherapy for cancer of the head and neck. In: Nag S, ed. High Dose Rate Brachytherapy: A Textbook. Armonk, NY: Future Publishing Company; 1994:237-273.
32. Levendag PC, Cees AM, Andries GV. Reirradiation of recurrent head and neck cancers: external and/or interstitial radiation therapy. Radiother Oncol. 1992;23:6-15.
33. Levendag PC, Meeuwis CA, Visser AG, et al. Reirradiation of recurrent head and neck cancers: external versus interstitial radiation therapy. Activity. 1992;3:32-39.
34. Kovács G, Rochels R, Mehdorn HM, et al. Möglichkeiten der intraoperativen interstitiellen Brachytherapy bei orbita- und schädelbasisnahen Tumoren. In: Draf W, ed. Entzündungen an der Schädelbasis. Reinbeck: Einhorn; 1994:200-207.
35. Kovács G. Pulsed dose rate brachytherapy for head and neck cancer. In: Bruggmoser G, Mould RF, eds. Freiburg Oncology Series Monograph, No 1: Brachytherapy Review. Madison: Medical Physics Publishing; 1994:171-180.
36. Kovács G, Kohr P, Zimmermann J, et al. Initial PDR brachytherapy experience at Kiel. In: Fietkau R, Mould RF, eds. Brachytherapy. State of the Art in Germany. Veenendaal: Nucletron International; 1993:88-97.
37. Strege RJ, Eichmann T, Holland D, et al. Combined operation and brachytherapy for pediatric malignancies involving the orbit and the skull base. Childs Nerv Syst. 2001;17:430-431.
38. Brockstein B. Management of sarcomas of the head and neck. Curr Oncol Rep. 2004;6:321-327.
39. Fee WE Jr, Goffinet DR, Paryani S, et al. Intraoperative iodine 125 implants. Their use in large tumors in the neck attached to the carotid artery. Arch Otolaryngol. 1983;109:727-730.
40. Lee D-J, Liberman FZ, Park RI, et al. Intraoperative I-125 seed implantation for extensive recurrent head and neck carcinomas. Radiology. 1991;178:879-882.
41. Martinez A, Goffinet DR, Fee W, et al. 125 Jodine implants as an adjuvant to surgery and external beam radiotherapy in the management of locally advanced head and neck cancer. Cancer. 1983;51:973-979.
42. Park RI, Liberman FZ, Lee D-J, et al. Jodine-125 seed implantation as an adjunct to surgery in advanced recurrent squamous cell cancer of the head and neck. Laryngoscope. 1991;101:405-410.
43. Sham JS, Wie WI, Choy D, et al. Treatment of persistent and recurrent nasopharyngeal carcinoma by brachytherapy. Br J Radiol. 1989;62:355-361.
44. Moscoso JF, Urken ML, Dalton J, et al. Simultaneous interstitial radiotherapy with regional or free-flap reconstruction, following salvage surgery of recurrent head and neck carcinoma. Arch Otolaryngol Head Neck Surg. 1994;120:965-972.
45. Smith RV, Krevitt L, Yi SM, et al. Early wound complications in advanced head and neck cancer treated with surgery and Ir192 brachytherapy. Laryngoscope. 2000;110:8-12.
46. Kremer B, Klimek L, Andreopoulos D, et al. A new method for the placement of brachytherapy probes in paranasal sinus and nasopharynx neoplasms. Int J Radiat Oncol Biol Phys. 1999;43:995-1000.
47. Wazer DE, Schmidt-Ullrich R, Chasin W, et al. High-dose boost irradiation techniques for carcinoma of the nasopharynx. Am J Otolaryngol. 1989;10:173-180.
48. Denham JW, Baldacchino AC, Gutte J, et al. Remote afterloading techniques for the treatment of nasopharyngeal and endometrial cancer. Int J Radiat Oncol Biol Phys. 1988;14:191-195.
49. Kim TH, Gerbi BJ, Deibel C, et al. An afterloading brachytherapy device utilizing thermoplastic material. Radiother Oncol. 1989;15:341-344.
50. Teo P, Tsao SY, Leung SF. Afterloading intracavitary radiation treatment of nasopharyngeal carcinoma. Acta Oncol. 1989;28:525-527.
51. Righi PD, Weisberger EC, KRakovits PR, et al. Wound complications associated with brachytherapy for primary or salvage treatment of head and neck cancer. Laryngoscope. 1997;107:1464-1468.
52. Stafford N, Dearnaley D. Treatment of 'inoperable' neck nodes using surgical clearance and postoperative interstitial irradiation. Br J Surg. 1988;75:62-64.
53. Langlois D, Hoffstetter S, Malissard L, et al. Salvage irradiation of oropharynx and mobile tongue about 192 iridium brachytherapy in Centre Alexis Vautrin. Int J Radiat Oncol Biol Phys. 1988;14:849-853.
54. Cornes PG, Cox HJ, Rhys-Evans PR, et al. Salvage treatment for inoperable neck nodes in head and neck cancer using combined iridium-192 brachytherapy and surgical reconstruction. Br J Surg. 1996;83:1620-1622.
55. Syed AMN, Feder BH, George FWI, et al. Iridium-192 afterload implant in the retreatment of head and neck cancers. Br J Radiol. 1978;51:814-820.
56. Schulz-Wendtland R, Wilhelm K-R, Bauer M, et al. Ä sthesioneuroblastom - Rezidivbehandlung mit Hilfe der ferngesteuerten After-loading-Technik. Strahlenther Onkol. 1990;166:147-150.
57. Bronen RA, Lee GL, Son YH, et al. CT-guided percutaneous insertion of interstitial radiotherapy catheters in head and neck tumors. J Comput Assist Tomogr. 1994;18:163-165.
58. Chambres O, Huy NH, Schultz P, et al. Surgical treatment of malignant sinonasal tumors with orbital extension: 20 patients. Ann Otolaryngol Chir Cervicofac. 2005;122:27-31.
59. Bale RJ, Freysinger W, Martin A, et al. Head and neck tumors: fractionated frameless stereotactic interstitial brachytherapy. Strahlenther Onkol. 1998;174:82-87.
60. Nag S, Cano ER, Demanes J, et al. The American brachytherapy society recommendations for high-dose-rate brachytherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys. 2001;50:1190-1198.
61. Siebert F-A, Born T, Häring S, et al. A dosimetric analysis of interstitial intensità modulated implants for pelvic recurrences, base of tongue and orbita tumors with specific references to the ICRU-58. Radiother Oncol. 2006;79:298-303.
62. Freeman SB, Hamaker RC, Singer MI, et al. Intraoperative radiotherapy of skull base cancer. Laryngoscope. 1991;101:507-509.
63. Muir CS, Nectoux J. Descriptive epidemiology of malignant neoplasms of nose, nasal cavities, middle ear and accessory sinuses. Clin Otolaryngol. 1980;5:195-211.
64. Dulguerov P, Jacobsen MS, Allal AS, et al. Nasal and paransal sinus carcinoma: are we making progress? A series of 220 patients and a systematic review. Cancer. 2001;92:3012-3029.
65. Ayiomamitis A, Parker L, Havas T. The epidemiology of malignant neoplasms of the nasal cavities, the paranasal sinuses and the middle ear in Canada. Arch Otorhinolaryngol. 1988;244:367-371.
66. Robin PE, Powell DJ, Stanbie JM. Carcinoma of the nasal cavity and paranasal sinuses: incidence and presentation of different histological types. Clin Otolaryngol. 1979;4:431-456.
67. Coebergh JWW, van der Heikden LH, Janssen-Heijnen MLG, eds. Cancer Incidence and Survival in the Southeast of the Netherlands 1955-1994. IKZ. Eindhoven: Comprehensive Cancer Centre South; 1994.
68. DeMonte F, Fourney DR, Garden AS, et al. Carcinoma of the paranasal sinuses and olfactory neuroblastoma. In: Berger MS, Prados MD, eds. Textbook of Neuro-oncology. Philadelphia, Pennsylvania: Elsevier Saunders; 2005:371-384.
69. Zheng W, McLaughlin JK, Chow WH, et al. Risk factors for cancers of the nasal cavity and paranasal sinuses among white men in the United States. Am J Epidemiol. 1993;138:965-972.
70. Thiel HJ, Rettinger G. Current status of detection and treatment of malignant nasal and paranasal sinus tumors. 1. Pathology, diagnosis and staging of nasal and paranasal sinus tumors. HNO. 1986;34:91-95. German.
71. Thiel HJ, Rettinger G. Current status of detection and treatment of malignant nasal and paranasal sinus tumors. 2. Therapy and results of treatment. HNO. 1986;34:96-107. German.
72. DeMonte F. Evolving role of skullbase surgery for patients with low and high grade malignancies. J Neuro-Oncol. 2004;69:191-198.
73. Jansen EP, Keus RB, Hilgers FJM, et al. Does the combination of radiotherapy and debulking surgery favor survival in paranasal sinus carcinoma? Int J Radiat Oncol Biol Phys. 2000;48:27-35.
74. Morita A, Sekhar LN, Wright DC. Current concepts in the management of tumors of the skull base. Cancer Control. 1998;5:138-149.
75. Russel JD, Bleach NR, Glaser M, et al. Brachytherapy for recurrent nasopharyngeal and nasoethmoidal tumours. J Laryngol Otol. 1993;107:115-120.
76. Grabenbauer GG, Rödel C, Brunner T, et al. Interstitial brachytherapy with Ir-192 low-dose-rate in the treatment of primary and recurrent cancer of the oral cavity and oropharynx. Strahlenther Onkol. 2001;177:338-344.
77. Sobin LH, Wittekind CH, eds. UICC TNM Classification of Malignant Tumours. 5th ed. New York: Wiley & Sons; 1997.
78. Fleming ID, Cooper JS, Henson DE, et al. eds. American Joint Committee on Cancer Staging Manual. 5th ed. Philadelphia: Lippincott; 1997.
79. Cantu G, Solero CL, Mariani L, et al. A new classification for malignant tumors involving the anterior skull base. Arch Otolaryngol Head Neck Surg. 1999;125:1252-1257.
80. Shah JP. Head and Neck Surgery. London, Baltimore, Barcelona: Mosby-Wolfe; 1996.
81. van Tuyl R, Gussack GS. Prognostic factors in craniofacial surgery. Laryngoscope. 1991;101:240-244.
82. Lund VJ, Howard DJ, Wei WI, et al. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 17-year experience. Head Neck. 1998;20:97-105.
83. Ketcham AS, Van Buren JM. Tumors of the paranasal sinuses: a therapeutic challenge. Am J Surg. 1985;150:406-413.
84. Ganly I, Patel SG, Singh B, et al. Craniofacial resection for malignant sinus tumors: report of an International Collaborative Study. Head Neck. 2005;27:575-584.
85. Rutter MJ, Furneaux CE, Morton RP. Craniofacial resection of anterior skull base tumours: factors contributing to success. Aust N Z J Surg. 1998;68:350-353.
86. Salvan D, Julieron M, Marandas P, et al. Combined transfacial and neurosurgical approach to malignant tumours of the ethmoid sinus. J Laryngol Otol. 1998;112:446-450.
87. Kelly MBH, Waterhouse N, Slade DE, et al. A 5-year review of 71 consecutive anterior skull base tumours. Br J Plastic Surg. 2000;53:184-190.
88. Nishizawa S, Yokota N, Yokoyama T, et al. Prevention of postoperative complications in skull base surgery for nasal or paranasal sinus carcinoma invading the skull base. J Clin Neurosci. 2001;8(suppl 1):67-70.
89. Ross DA, Hundal JS, Son YH, et al. Microsurgical free flap reconstruction outcomes in head and neck cancer patients after surgical extirpation and intraoperative brachytherapy. Laryngoscope. 2004;114:1170-1176.
90. Parsons JT, Mendenhall WM, Mancuso AA, et al. Malignant tumors of the nasal cavity and ethmoid and sphenoid sinuses. Int J Radiat Oncol Biol Phys. 1988;14:11-22.
91. Lunsford LD, Witt TC, Kondziolka D, et al. Stereotactic radiosurgery of anterior skull base tumors. Clin Neurosurg. 1995;42:99-118.
92. Kataoka K, Sumii T, Asai T, et al. Successful treatment of large malignant tumor involving the skull base by radiosurgery combined with intraarterial chemotherapy and embolization. Minim Invas Neurosurg. 2000;43:30-32.
93. Kocher M, Voges J, Staar S, et al. Linear accelerator radiosurgery for recurrent malignant tumors of the skull base. Am J Clin Oncol. 1998;21:18-22.
94. Miller RC, Foote RL, Coffey RJ, et al. The role of stereotactic radiosurgery in the treatment of malignant skull base tumors. Int J Radiat Oncol Biol Phys. 1997;39:977-981.
95. Habermann W, Zanarotti U, Groell R, et al. Combination of surgery and gamma knife radiosurgery - a therapeutic option for patients with tumors of nasal cavity or paranasal sinuses infiltrating the skull base. Acta Otorhinolaryngol Ital. 2002;22:74-79.
96. Wexler LH, Crist WM, Helman LJ. Rhabdomyosarcoma and the undifferentiated sarcomas. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkens; 2001.
97. Claviez A. Rhabdomyosarkome. In: Gutjahr P, ed. (Hrsg). Krebs bei Kindern und Jugendlichen. Köln: Deutscher Ärzte-Verlag; 2004.
98. Rutten I, Deneufbourg JM. Radiotherapy in pediatric head and neck tumours. Acta Otorhinolaryngol Belg. 2000;54:1-6.
99. Sommelet D, Pinkerton R, Brunat-Mentigny M, et al. Standards, options and recommendations (SOR) for clinical care of rhabdomyosarcoma (RMS) and other soft tissue sarcoma in children. Federation of the French Cancer Centers. French Society of Pediatric Oncology. Bull Cancer. 1998;85:1015-1042.
100. Neville HL, Raney RB, Andrassy RJ, et al. Multidisciplinary management of pediatric soft-tissue sarcoma. Oncology. 2000;14:1471-1481.
101. Karcioglu ZA, Hadjistilianou D, Rozans M, et al. Orbital rhabdomyosarcoma. Cancer Control. 2004;11:328-333.
102. Crist WM, Anderson JR, Meza JL, et al. Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. J Clin Oncol. 2001;19:3091-3102.
103. Cunningham MJ, Myers EN, Bluestone CD. Malignant tumors of the head and neck in children: a twenty-year review. Int J Pediatr Otorhinolaryngol. 1987;13:279-292.
104. Maurer HM, Gehan EA, Beltangady M, et al. The Intergroup Rhabdomyosarcoma Study-II. Cancer. 1993;71:1904-1922.
105. Mannor GE, Rose GE, Plowman PN, et al. Multidisciplinary management of refractory orbital rhabdomyosarcoma. Ophthalmology. 1997;104:1198-1201.
106. Crist WM, Garnsey L, Beltangady MS, et al. Prognosis in children with rhabdomyosarcoma: a report of the intergroup rhabdomyosarcoma studies I and II. Intergroup Rhabdomyosarcoma Committee. J Clin Oncol. 1990;8:443-452.
107. Crist W, Gehan EA, Ragab AH, et al. The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol. 1995;13:610-630.
108. Shields CL, Shields JA, Honavar SG, et al. Clinical spectrum of primary ophthalmic rhabdomyosarcoma. Ophthalmology. 2001;108:2284-2292.
109. Oberlin O, Anderson J, Carli M, et al. Treatment of orbital rhabdomyosarcoma: survival and late effects of treatment-results of an international workshop. J Clin Oncol. 2001;19:197-204.
110. Fiorillo A, Migliorati R, Vassallo P, et al. Radiation late effects in children treated for orbital rhabdomyosarcoma. Radiother Oncol. 1999;53:143-148.
111. Raney RB, Anderson JR, Kollath J, et al. Late effects of therapy in 94 patients with localized rhabdomyosarcoma of the orbit: report from the intergroup rhabdomyosarcoma study (IRS)-III, 1984-1991. Med Pediatr Oncol. 2000;34:413-420.
112. Abramson DH, Ellsworth RM, Tretter P, et al. The treatment of orbital rhabdomyosarcoma with irradiation and chemotherapy. Trans Am Acad Ophthalmol Otol. 1979;86:1330-1335.
113. Abramson DH, Notis C. Visual acuity after radiation for orbital rhabdomyosarcoma. Am J Opthalmol. 1994;118:808-809.
114. Lawrence W Jr, Hays DM. Surgical lessons from the Intergroup Rhabdomyosarcoma Study. Natl Cancer Inst Monogr. 1981;56:159-163.
115. Wijnaendts LC, van der Linden JC, van Unnik AJ, et al. Histopathological classification of childhood rhabdomyosarcomas: relationship with clinical parameters and prognosis. Hum Pathol. 1994;25:900-907.
116. Wang ZY, Xu WB. Experimental study on wound healing of bone after intraosseus HDR brachytherapy. In: Mould RF, ed. Brachytherapy in the People's Republic of China. Veenendaal: Nucletron; 1992:148-149.
117. Xu WB, Li B, Fu FZ, et al. HDR interstitial brachytherapy with iridium-192 afterloading: Technique for bone carcinoma. In: Mould RF, ed. Brachytherapy in the People's Republic of China. Veenendaal: Nucletron; 1992:149-150.
118. Mettler FA, Upton AC. Medical Effects of Ionizing Radiation. 2nd ed. Philadelphia: Saunders; 1995:231-234.
119. Heyn R, Haeberlen V, Newton WA, et al. Second malignant neoplasms in children treated for rhabdomyosarcoma. Intergroup rhabdomyosarcoma study commitee. J Clin Oncol. 1993;11:1005.