Wanebo H J, Temple W J, Popp M B, Douvill C E, Yablonski M
Brown University, Providence, RI.
Arch Surg. 1990 Mar;125(3):355-9. doi: 10.1001/archsurg.1990.01410150077014.
Patients with extremity sarcomas were treated with a neoadjuvant therapy protocol that had originated within the Southeastern Cancer Study Group. Major objectives were to determine tolerance of therapy and its effects on tumor control and survival. After undergoing biopsy, patients received intra-arterial infusion with doxorubicin hydrochloride (Adriamycin) (30 mg every 24 hours) for 3 days and were allocated by institution to receive irradiation of 30 or 35 Gy in 10 fractions or 46 Gy in 23 to 25 fractions. Surgery was done within 7 to 10 days or 30 days pending irradiation dose. Postoperative chemotherapy was given to 31 patients. There were 60 patients, 29 women and 31 men with a median age of 48 years, with 53 soft-tissue tumors and 7 malignant bone tumors. Stages (American Joint Committee on Cancer) included stage IB, 2 patients; stages IIA and IIB, 9 patients; stage IIIA, IIIB, or IIIC, 39 patients; and stages IVA or IVB, 10 patients. Limb salvage surgery was done in 57 patients, including radical resection in 23 with large extensive tumors, wide local excision in 30, excision with narrow margins in 7, primary amputation in 3, and delayed amputation in 2 because of wound complications. There was one local recurrence in the 57 patients who had limb salvage surgery. Disease-free and overall survival at 48 months were 47% and 56%, respectively. We conclude that combined therapy for extremity sarcomas in a multicenter setting resulted in excellent local control, good function, and reasonable long-term survival in patients having limb salvage surgery.
肢体肉瘤患者接受了一项由东南癌症研究小组发起的新辅助治疗方案。主要目的是确定治疗的耐受性及其对肿瘤控制和生存的影响。活检后，患者接受盐酸阿霉素（阿霉素）动脉内输注（每24小时30毫克），持续3天，并按机构分配接受10次分割照射30或35 Gy，或23至25次分割照射46 Gy。根据照射剂量，手术在7至10天或30天内进行。31例患者接受了术后化疗。共有60例患者，其中29例女性，31例男性，中位年龄48岁，有53例软组织肿瘤和7例恶性骨肿瘤。分期（美国癌症联合委员会）包括IB期2例；IIA期和IIB期9例；IIIA期、IIIB期或IIIC期39例；IVA期或IVB期10例。57例患者进行了保肢手术，其中23例因肿瘤广泛而进行根治性切除，30例进行广泛局部切除，7例进行边缘狭窄切除，3例进行一期截肢，2例因伤口并发症进行延迟截肢。在57例行保肢手术的患者中，有1例局部复发。48个月时的无病生存率和总生存率分别为47%和56%。我们得出结论，在多中心环境下对肢体肉瘤进行联合治疗，对于接受保肢手术的患者，可实现良好的局部控制、良好的功能和合理的长期生存。
