Lanza L A, Putnam J B, Benjamin R S, Roth J A
Department of Thoracic Surgery, University of Texas MD Anderson Cancer Center, Houston.
Ann Thorac Surg. 1991 Feb;51(2):219-24. doi: 10.1016/0003-4975(91)90789-s.
Between 1979 and 1988, 26 patients with pulmonary metastases from adult soft-tissue sarcomas were treated with Adriamycin (doxorubicin hydrochloride), Cytoxan (cyclophosphamide), and DTIC before metastasectomy. Thirty-eight thoracotomies were performed with postoperative complications in 5 patients (5/38, 13.2%) and one postoperative death (1/38, 2.6%). Two patients had benign lesions at thoracotomy and were excluded from further survival analysis. The median survival of the remaining 24 patients after thoracotomy was 18.5 +/- 5.9 months, and the actuarial 5-year survival was 22%. Five patients (5/24, 21%) achieved a clinically complete response with preoperative chemotherapy, but all had recurrence in the lung and underwent resection of pulmonary metastases. Seven patients (7/24, 29%) achieved a partial response and had residual disease resected at thoracotomy. Twelve patients (12/24, 50%) showed either no change or disease progression while receiving chemotherapy and were referred for resection. Postthoracotomy disease-free survival and postthoracotomy overall survival did not differ significantly between the three groups. One patient in the group showing no change or progression of disease while receiving chemotherapy is alive without recurrence 57 months after initial pulmonary metastasectomy. Chemotherapy can be used for the initial treatment of pulmonary metastases from adult soft-tissue sarcomas. However, survival after resection of pulmonary metastases cannot be accurately predicted based on the clinical response to preoperative chemotherapy.
1979年至1988年期间，26例成人软组织肉瘤肺转移患者在转移灶切除术前接受了阿霉素（盐酸多柔比星）、环磷酰胺和达卡巴嗪治疗。共进行了38次开胸手术，5例患者（5/38，13.2%）出现术后并发症，1例患者术后死亡（1/38，2.6%）。2例患者开胸时发现为良性病变，被排除在进一步的生存分析之外。其余24例患者开胸术后的中位生存期为18.5±5.9个月，5年精算生存率为22%。5例患者（5/24，21%）术前化疗获得临床完全缓解，但均出现肺部复发并接受了肺转移灶切除术。7例患者（7/24，29%）获得部分缓解，开胸时切除了残留病灶。12例患者（12/24，50%）在接受化疗时病情无变化或进展，随后接受了切除术。三组患者开胸术后无病生存期和开胸术后总生存期差异无统计学意义。1例在接受化疗时病情无变化或进展的患者，在初次肺转移灶切除术后57个月仍存活且无复发。化疗可用于成人软组织肉瘤肺转移的初始治疗。然而，根据术前化疗的临床反应无法准确预测肺转移灶切除术后的生存期。
