Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Acta Oncol. 2013 May;52(4):745-52. doi: 10.3109/0284186X.2012.709947. Epub 2012 Aug 30.
To evaluate long-term local control, survival, radiation side effects and functional outcome after limb-sparing surgery followed by postoperative radiotherapy (RT) for soft tissue sarcoma (STS).
Between 1995 and 2010, 118 patients with STS of an extremity were treated with limb-sparing surgery and postoperative RT. Follow-up was complete for all patients. Acute and late radiation related toxicities were scored using CTCAE v4.0.
Median follow-up was 93 months. RT dose was 60 Gy in 92.4% of the patients; 5.1% received 66 Gy; 2.5% 50-56 Gy. Actuarial local recurrence rates at five and 10 years were 9% and 12%. Five- and 10-year overall survival rates were 69% and 51%. Acute radiation toxicities occurred in 91% of the patients; 19% were grade 3, 2% grade 4. Late radiation toxicities were reported in 71% of the patients: 50% grade 1, 18% grade 2, and 3% grade 3. Limb and joint function after treatment were good, 19% having mild limitation of motion, 1.5% moderate, and 2.5% severe limitations.
Limb-sparing surgery with 60 Gy postoperative radiotherapy for patients with STS provides excellent local control and high survival rates with acceptable toxicity and functional outcomes.
评估保肢手术后行术后放疗（RT）治疗软组织肉瘤（STS）的长期局部控制、生存、放射副作用和功能结局。
1995 年至 2010 年间，118 例肢体 STS 患者接受保肢手术和术后 RT 治疗。所有患者均完成随访。采用 CTCAE v4.0 对急性和迟发性放射相关毒性进行评分。
中位随访时间为 93 个月。92.4%的患者接受 60 Gy 的 RT 剂量；5.1%接受 66 Gy；2.5%接受 50-56 Gy。5 年和 10 年的局部复发率分别为 9%和 12%。5 年和 10 年的总生存率分别为 69%和 51%。91%的患者出现急性放射毒性；19%为 3 级，2%为 4 级。71%的患者报告有迟发性放射毒性：50%为 1 级，18%为 2 级，3%为 3 级。治疗后肢体和关节功能良好，19%运动轻度受限，1.5%中度受限，2.5%严重受限。
STS 患者行保肢手术联合 60 Gy 术后 RT 可获得极好的局部控制和高生存率，毒性和功能结局可接受。
