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[调强放疗作为腹膜后肉瘤术后辅助治疗:急性毒性反应]

[Intensity modulated radiotherapy as adjuvant post-operative treatment for retroperitoneal sarcoma: acute toxicity].

作者信息

Paumier A, Bonvalot S, Beaudré A, Terrier P, Rimareix F, Domont J, Le Cesne A, Roberti E, Lefkopoulos D, Le Péchoux C

机构信息

Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114 rue Édouard-Vaillant, Villejuif, France.

出版信息

Cancer Radiother. 2011 Aug;15(5):413-20. doi: 10.1016/j.canrad.2011.04.002. Epub 2011 Jul 6.

Abstract

PURPOSE

To assess the acute toxicity of intensity modulated radiotherapy as post-operative adjuvant treatment for retroperitoneal sarcoma.

PATIENTS AND METHODS

Patients who received adjuvant intensity modulated radiotherapy from January 2009 to September 2010 were retrospectively reviewed.

RESULTS

Fourteen patients entered the study (seven primary tumours and seven relapses). All tumours were liposarcoma and had macroscopically complete resection, epiploplasty was systematically realized. Median tumour size was 21 cm (range: 15-45), median planning target volume was 580 cm(3) (range: 329-1172) and median prescribed dose was 50.4 Gy (range: 45-54). Median follow-up was 11.5 months (range: 2-21.4). Acute toxicity was mild: acute digestive toxicity grade 1-2 occurred in 12/14 patients (86%). However, there was no weight loss of more than 5% during radiotherapy and no treatment interruption was required. Two months after completion of radiotherapy, digestive toxicity grade 1 remained present in 1/14 patients (7%). One case of grade 3 toxicity occurred during follow-up (transient abdominal pain). Three relapses occurred: two were outside treaded volume and one was both in and outside treated volume.

CONCLUSIONS

Intensity modulated radiotherapy in the postoperative setting of retroperitoneal sarcoma provides low acute toxicity. Longer follow-up is needed to assess late toxicity, especially for bowel, kidney and radio-induced malignancies.

摘要

目的

评估调强放疗作为腹膜后肉瘤术后辅助治疗的急性毒性。

患者与方法

回顾性分析2009年1月至2010年9月接受辅助调强放疗的患者。

结果

14例患者进入研究(7例原发性肿瘤和7例复发病例)。所有肿瘤均为脂肪肉瘤,且肉眼下完全切除,均系统性地实施了网膜成形术。肿瘤中位大小为21 cm(范围:15 - 45),中位计划靶体积为580 cm³(范围:329 - 1172),中位处方剂量为50.4 Gy(范围:45 - 54)。中位随访时间为11.5个月(范围:2 - 21.4)。急性毒性较轻:12/14例患者(86%)发生1 - 2级急性消化毒性。然而,放疗期间体重减轻未超过5%,且无需中断治疗。放疗结束后2个月,1/14例患者(7%)仍存在1级消化毒性。随访期间发生1例3级毒性(短暂腹痛)。发生3例复发:2例在照射野之外,1例在照射野内及照射野之外。

结论

腹膜后肉瘤术后调强放疗的急性毒性较低。需要更长时间的随访来评估晚期毒性,尤其是肠道、肾脏和放射性诱发的恶性肿瘤的毒性。

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