Department of Orthopaedics, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy 3065, Victoria, Melbourne, Australia.
Eur J Surg Oncol. 2010 Jul;36(7):678-83. doi: 10.1016/j.ejso.2010.05.021. Epub 2010 Jun 12.
To assess the significance of change in tumour size during preoperative radiotherapy in patients with soft tissue sarcoma (STS).
A retrospective review of 91 cases with STS was performed. Inclusion criteria were localised extremity and truncal STS with measurable disease, older than 18 years, treated with preoperative radiotherapy and wide local excision, in the period between January 1966 and December 2005. Patients with head and neck STS, or who received neoadjuvant chemotherapy were excluded. A difference in excess of 10% of the greatest tumour diameter of the pre-radiotherapy and the post-radiotherapy MRI scans was considered as change in tumour size.
Increase in tumour size was noted in 28 patients (31%) (Group 1). No change or decrease in size was observed in 63 patients (Group 2). There were no significance differences in local control or overall survival rates between the 2 groups. The estimated overall actuarial local recurrence free, event-free and overall survival rates were 90.5%, 64.4%, 62.9% in Group 1, and 85.7%, 60.8%, 68.9% in Group 2 respectively.
Increase in tumour size during preoperative radiotherapy for soft tissue sarcoma does not seem to associate with inferior local tumour control or compromise survival. Lack of reduction in tumour size is not necessarily a sign of lack of response to preoperative radiotherapy.
评估软组织肉瘤（STS）患者术前放疗过程中肿瘤大小变化的意义。
回顾性分析了 91 例 STS 患者。纳入标准为局限性四肢和躯干 STS，可测量病变，年龄大于 18 岁，接受术前放疗和广泛局部切除术，治疗时间为 1966 年 1 月至 2005 年 12 月。排除头颈部 STS 患者或接受新辅助化疗的患者。将术前和术后 MRI 扫描中最大肿瘤直径的差异超过 10%视为肿瘤大小的变化。
28 例（31%）患者的肿瘤大小增加（第 1 组）。63 例患者肿瘤大小无变化或减小（第 2 组）。两组患者的局部控制率或总生存率无显著差异。第 1 组的总局部无复发生存率、无事件生存率和总生存率估计分别为 90.5%、64.4%和 62.9%，第 2 组分别为 85.7%、60.8%和 68.9%。
术前放疗期间软组织肉瘤肿瘤大小的增加似乎与局部肿瘤控制不良或生存受损无关。肿瘤大小无减小并不一定是术前放疗无反应的迹象。
