Schmitt G, Mills E E, Levin V, Smit B J, Boecker H, Pape H
Klinik für Strahlentherapie und Radiologische Onkologie, Universität Düsseldorf, Germany.
Eur J Cancer. 1992;28A(4-5):832-5. doi: 10.1016/0959-8049(92)90125-l.
The long term results of 24 patients treated with postoperative irradiation for aggressive fibromatosis are presented. Tumour sites were the pelvis (8), chest wall (5), shoulder (5), extremities (4) and head and neck (2). Macroscopic complete resection (R1) was performed in 3 cases. 17 patients presented postoperatively with gross disease (R2), 8 of which were recurrent tumours. 4 patients with inoperable disease had biopsies only. Radiation doses ranged from 28 to 64 Gy at a fractionation of 5 x 2 or 4 x 2.5 Gy/week. 4 patients had external irradiation in combination with 192Ir implants, 2 were irradiated with implants alone. In the combined treatment group, external doses ranged from 28 to 52 Gy and additional interstitial doses from 35 to 50 Gy. 192Ir treatment alone was given with 45 and 57 Gy to the contour of the target volume. The 10 year recurrence free survival rate is 75%. A dose response relationship has been established in the dose range of 30-60 Gy revealing an expected 80% persistent tumour control rate at 60 Gy. A dose volume relationship however, could not be derived from our data. Moderate fibrosis without functional impairment developed in 5 patients (21%). These data support a policy of postoperative radiotherapy with 60 Gy in patients with incompletely excised or gross residual tumour following surgery.
本文介绍了24例侵袭性纤维瘤病患者术后放疗的长期结果。肿瘤部位包括骨盆（8例）、胸壁（5例）、肩部（5例）、四肢（4例）和头颈部（2例）。3例患者进行了宏观完全切除（R1）。17例患者术后出现肉眼可见的病变（R2），其中8例为复发性肿瘤。4例无法手术的患者仅进行了活检。放疗剂量范围为28至64 Gy，分割方式为每周5×2或4×2.5 Gy。4例患者接受了外照射联合192Ir植入，2例仅接受了植入照射。在联合治疗组中，外照射剂量范围为28至52 Gy，额外的组织间照射剂量为35至50 Gy。单独进行192Ir治疗时，靶体积轮廓的照射剂量为45和57 Gy。10年无复发生存率为75%。在30 - 60 Gy的剂量范围内建立了剂量反应关系，显示在60 Gy时预期的肿瘤持续控制率为80%。然而，我们的数据未能得出剂量体积关系。5例患者（21%）出现了无功能障碍的中度纤维化。这些数据支持对术后切除不完全或有肉眼残留肿瘤的患者采用60 Gy术后放疗的策略。
