Avizonis V N, Sause W T, Menlove R L
Radiation Center, LDS Hospital, Salt Lake City, Utah 84143.
J Surg Oncol. 1990 Oct;45(2):85-90. doi: 10.1002/jso.2930450206.
Seventy-four adult patients with localized soft tissue sarcomas were treated with radiation therapy following surgery between 1965 and 1988. Fifty-three were treated after the first excision of their tumor with 6 (11.3%) local recurrences. Twenty-one received radiation after excision of recurrent disease with 11 (52.4%) local failures (P less than .0005). Metastatic disease occurred in 14 (26.4%) of the primary tumors and 8 (38.1%) with multiple previous excisions (P less than .48). Of those patients treated for primary sarcoma, there were no local failures with pathologically wide margins or if a single margin was microscopically positive. Local failure occurred in 4 of 26 (15.4%) if the tumor was merely enucleated and in 2 of 11 (18.2%) who had grossly positive surgical margins (P not significant). Local failure was also more common in truncal locations (33.3%) as compared with extremity locations (8.7%, P = .1359). Additional factors analyzed which adversely affected prognosis included tumor grade, stage, and inadequate radiation dose.
1965年至1988年间，74例患有局限性软组织肉瘤的成年患者在手术后接受了放射治疗。53例患者在首次切除肿瘤后接受治疗，其中6例（11.3%）出现局部复发。21例在复发性疾病切除后接受放疗，其中11例（52.4%）出现局部失败（P<0.0005）。14例（26.4%）原发性肿瘤发生转移，8例（38.1%）先前有多次切除史的患者发生转移（P<0.48）。在接受原发性肉瘤治疗的患者中，病理切缘阴性或仅一个切缘镜下阳性的患者未出现局部失败。如果肿瘤仅行剜除术，26例中有4例（15.4%）出现局部失败；手术切缘肉眼阳性的11例中有2例（18.2%）出现局部失败（P无统计学意义）。与四肢部位（8.7%，P = 0.1359）相比，躯干部位的局部失败也更常见（33.3%）。分析显示对预后有不利影响的其他因素包括肿瘤分级、分期和放疗剂量不足。
