摘要
目的术后放疗是软组织肉瘤综合治疗的重要组成部份,本研究通过对近10年来北京大学肿瘤医院收治的软组织肉瘤术后患者进行回顾性分析,旨在探讨软组织肉瘤术后放射治疗的疗效和预后影响因素。方法选取2008-03-01-2017-05-31日北京大学肿瘤医院收治的392例软组织肉瘤患者作为研究对象,所有患者均接受术后放疗。其中,低度恶性269例,中度恶性61例,高度恶性62例;多次术后复发31例,首次术后复发82例。术后放疗全部采用6 MV或10 MV深部X线外照射,加或不加6~15 MeV电子线照射,总剂量PTV低度恶性肉瘤为45~60Gy/5周,中度恶性肉瘤为65Gy/6.5周,高度恶性肉瘤或切缘残留为70Gy/7周。应用寿命表法统计生存率,应用Kaplan-Meier法进行预后的单因素分析,应用Cox比例风险模型进行预后多因素回归分析。结果随访8~118个月,中位随访时间为60个月。中位生存时间为30个月,1、3和5年生存率分别为92.1%(361/392)、81.9%(321/392)和61.5%(241/392),5年局部复发率为5.9%(23/392),5年远处转移率为13.0%(51/392)。单因素分析显示,肿瘤大小、患者性别、临床分期、恶性程度、调强放疗与预后密切相关,均P值<0.05。多因素分析显示,临床分期、肿瘤大小、恶性程度和调强放疗具有独立预后意义,均P值<0.05。结论术后放疗能提高软组织肉瘤患者生存率,降低术后局部复发率。
OBJECTIVE Radiotherapy is one important means of comprehensive treatment of soft tissue sarcoma. The aim is to observe and know the effect of postoperative radiotherapy for soft tissue sarcoma by retrospective analysis. METHODS From March 01,2008 to May 31,2017,392 cases（including 113 cases had been repeatedly resected and 279 cases first resected） with soft tissue sarcoma were all treated by radiotherapy of 6 MV or 10 MV deep x-ray after re- section, plus or not 9-15 Mev electron beam. The first was routine irradiation of 45--50 Gy for 5 weeks, and then contin- uously treated by deep x-ray on reduced field. The dose was PTV 60 Gy for 6 weeks on low degree malignant sarcoma, 65 Gy for 6.5 weeks on middle degree sarcome and 70 Gy for 7 weeks on high degree sarcoma. RESULTS 1-year-survival rate was 92.1%（361/392）,3 year-survival rate was 83.4%（327/392）,5-year-survival rate was 61.5%（241/392）,5-year local relapse rate was 5.9 % （23/392）, and distant metastatic rate was 13.0% （51/392）. Prognostic factors were the size of tumor,tumour degree of maligniancy and stage clinical stages（P-0.05）. CONCLUSION Radiotherapy can greatly decrease the local relapsed rate and improve survival rate after operation for soft tissue sarcoma.
作者
肖绍文
刘长青
方志伟
刘佳勇
肖卜凡
刘萌
郑晔
王维虎
XIAO Shao-wen;LIU Chang-qing;FANG Zhi wei;LIU Jia yong;XIAO Bu- fan;LIU Meng;ZHENG Ye;WANG Wei-hu(Peking University Cancer Hospital, Beijing Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education ） , Beijing 100142, P. R. China;Department of orthopaedics, First Medical College, Nanchang University, Nanchang 330031 , P. R. China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2018年第8期578-580,585,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
软组织肉瘤
术后放疗
预后
影响因素
soft tissue sarcoma
postoperative radiotherapy
prognosis
affective factor
