Delannes M, Thomas L, Brun T, David I, Ducassou A
Département de radiothérapie, institut Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse cedex, France.
Cancer Radiother. 2013 Apr;17(2):151-4. doi: 10.1016/j.canrad.2012.12.009. Epub 2013 Feb 9.
The standard of care of local treatment for extremities soft tissue sarcomas relies on conservative surgery combined with external beam radiotherapy. Brachytherapy can be realized instead of external beam radiotherapy in selected cases, or more often used as a boost dose on a limited volume on the area at major risk of relapse, especially if a microscopic positive resection is expected. In these cases, this combination allows to obtain the best local control rates published. Close interaction and communication between radiation oncologist and surgeon are mandatory at the time of implantation to limit the risk of side effects. Long-term results are available for low-dose rate brachytherapy. Nowadays, pulsed dose rate is more often used. More limited experience has been reported for high dose rate.
四肢软组织肉瘤局部治疗的护理标准依赖于保守手术联合外照射放疗。在特定情况下,可采用近距离放疗替代外照射放疗,或者更常用于对复发风险较高区域的有限体积进行追加剂量照射,特别是在预计切除边缘镜下阳性的情况下。在这些情况下,这种联合治疗能够实现已公布的最佳局部控制率。在植入时,放射肿瘤学家和外科医生之间密切的互动和沟通是必要的,以限制副作用风险。低剂量率近距离放疗已有长期结果。如今,脉冲剂量率更常被使用。高剂量率的经验报道较少。