Division of Radiation Oncology, McGill University Heath Center, Canada.
Radiother Oncol. 2010 Dec;97(3):404-7. doi: 10.1016/j.radonc.2010.10.007. Epub 2010 Oct 30.
To report radiological and pathological response to neo-adjuvant radiotherapy for extremity and trunk soft-tissue sarcomas.
MATERIALS/METHODS: Fifty patients were identified retrospectively. All patients had MRI imaging pre and post neo-adjuvant external beam radiotherapy. Tumor volumes were measured in 3D on T1 Gadolinium enhanced sequences. Pathological treatment response was quantified in terms of percentage of treatment-related necrosis for each case.
Histopathologic responses to treatment varied from 0% to 100%. The median pathological treatment response was 67.5% for low-grade sarcomas and 50% for high-grade sarcomas. The median decrease in tumor volume was 13.8% for non-myxoid low-grade sarcomas, 82.1% for myxoid liposarcomas and <1% for high-grade sarcomas. A partial response on MRI (volume reduction ≥50%) was highly predictive of a good pathological response (p<0.001). Patients with stable disease on imaging or volumetric progression had wide ranging pathological responses.
Soft-tissue sarcomas show significant pathological treatment responses in the form of hyaline fibrosis, necrosis and granulation tissue. Despite this, there is minimal early volumetric response to radiation, especially for high-grade tumors. Although radiological partial response was predictive of pathological response, the significance of radiological progression was unclear. Myxoid liposarcoma tumor type was predictive of both pathological and radiological tumor response.
报告四肢和躯干软组织肉瘤新辅助放疗的影像学和病理学反应。
材料/方法：回顾性地确定了 50 名患者。所有患者均接受新辅助外照射放疗前后的 MRI 成像。在 T1 钆增强序列上以 3D 方式测量肿瘤体积。根据每个病例的治疗相关坏死百分比来量化病理治疗反应。
治疗的组织病理学反应从 0%到 100%不等。低级别肉瘤的中位病理治疗反应为 67.5%，高级别肉瘤为 50%。非黏液样低级别肉瘤的肿瘤体积中位数减少 13.8%，黏液样脂肪肉瘤减少 82.1%，高级别肉瘤减少<1%。MRI 上的部分反应（体积减少≥50%）高度预测良好的病理反应（p<0.001）。影像学上疾病稳定或体积进展的患者病理反应范围广泛。
软组织肉瘤以透明样纤维化、坏死和肉芽组织的形式表现出明显的治疗病理学反应。尽管如此，尤其是对于高级别肿瘤，放射治疗的早期体积反应很小。虽然影像学上的部分缓解预测了病理反应，但影像学进展的意义尚不清楚。黏液样脂肪肉瘤的肿瘤类型对病理和影像学肿瘤反应均有预测作用。
