Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
J Surg Oncol. 2012 May;105(6):570-6. doi: 10.1002/jso.22122. Epub 2011 Oct 19.
Previous studies reported on post-radiation sarcomas. However, the incidence, latency from radiation therapy, treatment, and survival has been difficult to evaluate. We performed a retrospective, single-institutional study to determine these factors for post-radiation sarcomas.
We retrospectively studied 52 patients with post-radiation sarcomas diagnosed and treated from 1985 to 2011. The mean age was 49 years; 45 patients had bone and 7 soft tissue sarcoma. The mean follow-up was 45 months. Survival was analyzed with respect to age at diagnosis, type (bone vs. soft tissue), histology, location (trunk vs. extremities), size, and surgical treatment (resection vs. amputation).
The risk of post-radiation sarcoma was 0.06% at a mean latency of 15 years (3-50 years) after radiation therapy. The most common histology was osteosarcoma followed by malignant fibrous histiocytoma and fibrosarcoma; all sarcomas were high grade. Survival of the patients with post-radiation sarcomas was 85% at 1 year, 51% at 2 years, 48% at 3 years, and 45% at 5 years. Univariate predictor of survival was only the type of the sarcoma. No variable was significant in multivariate analysis.
Prognosis of post-radiation sarcomas is poor; the type of the sarcomas is the only significant variable for survival.
先前的研究报告了放疗后肉瘤。然而,放疗后肉瘤的发病率、潜伏期、治疗方法和生存率一直难以评估。我们进行了一项回顾性、单机构研究,以确定放疗后肉瘤的这些因素。
我们回顾性研究了 52 例 1985 年至 2011 年诊断和治疗的放疗后肉瘤患者。平均年龄为 49 岁;45 例为骨肉瘤,7 例为软组织肉瘤。平均随访时间为 45 个月。生存分析考虑了诊断时的年龄、类型(骨 vs. 软组织)、组织学、位置(躯干 vs. 四肢)、大小和手术治疗(切除 vs. 截肢)。
放疗后肉瘤的风险为 0.06%,潜伏期平均为 15 年(3-50 年)。最常见的组织学类型是骨肉瘤,其次是恶性纤维组织细胞瘤和纤维肉瘤;所有肉瘤均为高级别。放疗后肉瘤患者的 1 年生存率为 85%,2 年生存率为 51%,3 年生存率为 48%,5 年生存率为 45%。单因素生存预测因素仅为肉瘤的类型。多因素分析中无变量有意义。
放疗后肉瘤的预后较差;肉瘤的类型是生存的唯一显著变量。