Kang Josephine, Botros Maikel, Goldberg Saveli, Giraud Christine, Nielsen G Petur, Chen Yen-Lin, Raskin Kevin, Schwab Joseph, Yoon Sam S, Hornicek Francis J, Delaney Thomas F
Harvard Radiation Oncology Program, Boston, MA 02215, USA ; Flushing Radiation Oncology Services, Queens, NY 11354, USA.
Sarcoma. 2013;2013:485483. doi: 10.1155/2013/485483. Epub 2013 Jan 15.
Background and Objectives. Atypical lipomas are uncommon, slow-growing benign tumors. While surgery has been the primary treatment modality, we have managed some patients with radiation (RT) as a component of the treatment and have reported their outcomes in this study. Methods. A retrospective review of all cases of extremity and trunk atypical lipomas in The Sarcoma Database at the study institution was conducted. Results. Thirteen patients were identified. All patients underwent surgical resection at initial presentation and received pre- or postoperative radiation for subtotal resection (n = 2), local recurrence (n = 8), or progressive disease (n = 3). The median total radiation dose was 50 Gy. Median followup was 65.1 months. All patients treated with RT remained free of disease at the last followup. No grade 3 or higher late toxicity from radiation was observed. No cases of tumor dedifferentiation occurred. Conclusion. For recurrent or residual atypical lipomas, a combination of reexcision and RT can provide long-term local control with acceptable morbidity. For recurrent tumors, pre-op RT of 50 Gy appears to be an effective and well-tolerated management approach.
背景与目的。非典型脂肪瘤是罕见的、生长缓慢的良性肿瘤。虽然手术一直是主要的治疗方式，但我们将放疗作为部分患者治疗方案的一部分，并在本研究中报告了其治疗结果。方法。对研究机构肉瘤数据库中所有肢体和躯干非典型脂肪瘤病例进行回顾性分析。结果。共确定了13例患者。所有患者初次就诊时均接受了手术切除，并因次全切除（n = 2）、局部复发（n = 8）或疾病进展（n = 3）接受了术前或术后放疗。中位总放疗剂量为50 Gy。中位随访时间为65.1个月。所有接受放疗的患者在最后一次随访时均无疾病复发。未观察到3级或更高等级的放疗晚期毒性反应。未发生肿瘤去分化病例。结论。对于复发性或残留性非典型脂肪瘤，再次切除与放疗相结合可实现长期局部控制，且并发症可接受。对于复发性肿瘤，50 Gy的术前放疗似乎是一种有效且耐受性良好的治疗方法。
