Oertel Susanne, Treiber Martina, Zahlten-Hinguranage Angelika, Eichin Steffen, Roeder Falk, Funk Angela, Hensley Frank W, Timke Carmen, Niethammer Andreas G, Huber Peter E, Weitz Juergen, Eble Micheal J, Buchler Markus W, Bernd Ludger, Debus Jürgen, Krempien Robert C
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany.
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1416-23. doi: 10.1016/j.ijrobp.2005.10.009. Epub 2006 Jan 18.
To analyze long-term prognosis and morbidity after limb-sparing treatment of patients with extremity soft-tissue sarcoma, with intraoperative electron boost radiotherapy (IOERT) followed by a moderate dose of external beam radiotherapy (EBRT).
A total of 153 patients who were treated in a single center from 1991 to 2004 were evaluated. Median IOERT dose was 15 Gy, mean EBRT dose 43 Gy (range, 40-50.4 Gy) in conventional fractionation (1.8-2 Gy). Median duration of follow-up was 33 months. Acute toxicity was assessed with Common Toxicity Criteria; late toxic effects were scored according to European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria.
Five-year overall survival and 5-year local control rates were 77% and 78%, respectively. Whereas tumor size, patient age, and EBRT dose did not significantly affect outcome, resection status and grading were significant for survival; resection status and IOERT dose were significant for local control. Extremity salvage until death or time of follow-up was achieved in 90% of our patients, 86% of whom showed excellent limb function without impairment in activities of daily life. Acute toxicity Grade 2-4 was observed in 23% and late toxicity Grade 2-4 in 17% of patients.
Treatment with IOERT combined with moderate doses of external beam irradiation yields high local control and extremity preservation rates in resected extremity soft-tissue sarcoma.
分析肢体软组织肉瘤患者保肢治疗后，术中电子线追加放疗（IOERT）联合中等剂量外照射放疗（EBRT）的长期预后和发病率。
对1991年至2004年在单一中心接受治疗的153例患者进行评估。IOERT中位剂量为15 Gy，EBRT平均剂量为43 Gy（范围40 - 50.4 Gy），采用常规分割放疗（1.8 - 2 Gy）。中位随访时间为33个月。急性毒性按照通用毒性标准进行评估；晚期毒性效应根据欧洲癌症研究与治疗组织/放射肿瘤学组标准进行评分。
5年总生存率和5年局部控制率分别为77%和78%。肿瘤大小、患者年龄和EBRT剂量对预后无显著影响，而切除状态和分级对生存率有显著影响；切除状态和IOERT剂量对局部控制有显著影响。90%的患者直至死亡或随访时实现了肢体保全，其中86%的患者肢体功能良好，日常生活活动未受影响。23%的患者出现2 - 4级急性毒性，17%的患者出现2 - 4级晚期毒性。
IOERT联合中等剂量外照射放疗治疗切除的肢体软组织肉瘤可获得较高的局部控制率和肢体保全率。
