Pisters Peter W T, Ballo Matthew T, Patel Shreyaskumar R
Multidisciplinary Sarcoma Center, The University of Texas M. D. Anderson Cancer Center, Houston 77030-4009, USA.
Ann Surg Oncol. 2002 Jul;9(6):535-42. doi: 10.1007/BF02573888.
Over the past 2 decades, there has been increasing interest in chemoradiation treatment strategies for patients with soft tissue sarcomas. Investigators have evaluated: (1) the optimal route for chemotherapy administration (intra-arterial vs. intravenous); (2) the possible advantages of protracted infusion of the radiosensitizer versus brief infusion; (3) the efficacy and toxicity of various intravenous and oral radiation sensitizers; and (4) the efficacy of sequential versus concurrent combined modality treatment.
The English-language literature addressing chemoradiation for localized and locally advanced extremity and retroperitoneal sarcomas was reviewed.
All studies have been pilot, phase I, or phase II designs. The most commonly used radiosensitizer for concurrent chemoradiation has been doxorubicin, administered intravenously in most recent reports. In the studies that have included assessment of recurrence-free survival, preoperative chemoradiation combined with surgery has resulted in favorable local control rates, often in excess of 90% for patients with localized and locally advanced extremity sarcomas.
The toxicities and recurrence-free outcome with chemoradiation plus surgery for soft tissue sarcoma still need to be compared to these with surgery and pre- or postoperative radiation. However, the generally favorable local control rates reported for chemoradiation justify continued investigation of preoperative chemoradiation strategies for localized sarcoma.
在过去20年中，软组织肉瘤患者的放化疗治疗策略越来越受到关注。研究人员评估了：（1）化疗给药的最佳途径（动脉内给药与静脉内给药）；（2）长时间输注放射增敏剂与短时间输注相比可能具有的优势；（3）各种静脉内和口服放射增敏剂的疗效和毒性；以及（4）序贯联合治疗与同步联合治疗的疗效。
对关于局限性和局部晚期肢体及腹膜后肉瘤放化疗的英文文献进行了综述。
所有研究均为试验性、I期或II期设计。同步放化疗最常用的放射增敏剂是阿霉素，在最近的报告中多采用静脉给药。在包括无复发生存评估的研究中，术前放化疗联合手术已取得了良好的局部控制率，对于局限性和局部晚期肢体肉瘤患者，该比率通常超过90%。
软组织肉瘤放化疗联合手术的毒性和无复发生存结果仍需与手术联合术前或术后放疗的结果进行比较。然而，放化疗报告的总体良好局部控制率证明继续研究局限性肉瘤的术前放化疗策略是合理的。
