Lazarides Alexander L, Eward William C, Speicher Paul J, Hou Chun-Han, Nussbaum Daniel P, Green Cindy, Blazer Dan G, Kirsch David G, Brigman Brian E
School of Medicine, Duke University, Durham, NC 27710, USA.
Department of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Sarcoma. 2015;2015:186581. doi: 10.1155/2015/186581. Epub 2015 May 7.
Objective. This study investigated patterns of utilization of radiation therapy (RT) and correlated this with overall survival by assessing patients with well-differentiated soft tissue sarcoma of the extremity (STS-E) in the National Cancer Database (NCDB). Methods. All patients diagnosed with well-differentiated STS-E between 1998 and 2006 were identified in the NCDB. Patients were stratified by use of surgery alone versus use of adjuvant RT after surgery and analyzed using multivariate analysis, Kaplan-Meier analysis, and propensity matching. Results. 2113 patients with well-differentiated STS-E were identified in the NCDB for inclusion with a mean follow-up time of 74 months. 69% of patients were treated with surgery alone, while 26% were treated with surgery followed by adjuvant RT. Patients undergoing amputation were less likely to receive adjuvant RT. There was no difference in overall survival between patients with well-differentiated STS treated with surgery alone and those patients who received adjuvant RT. Conclusions. In the United States, adjuvant RT is being utilized in a quarter of patients being treated for well-differentiated STS-E. While the use of adjuvant RT may be viewed as a means to facilitate limb salvage, this large national database review confirms no survival benefit, regardless of tumor size or margin status.
目的。本研究通过评估国家癌症数据库（NCDB）中四肢高分化软组织肉瘤（STS-E）患者，调查放射治疗（RT）的使用模式，并将其与总生存率相关联。方法。在NCDB中识别出1998年至2006年间所有诊断为高分化STS-E的患者。患者按单纯手术治疗与术后辅助放疗进行分层，并采用多变量分析、Kaplan-Meier分析和倾向匹配法进行分析。结果。在NCDB中识别出2113例高分化STS-E患者纳入研究，平均随访时间为74个月。69%的患者接受单纯手术治疗，而26%的患者接受手术加辅助放疗。接受截肢的患者接受辅助放疗的可能性较小。单纯手术治疗的高分化STS患者与接受辅助放疗的患者总生存率无差异。结论。在美国，四分之一接受高分化STS-E治疗的患者使用辅助放疗。虽然辅助放疗的使用可被视为促进保肢的一种手段，但这项大型全国性数据库回顾证实，无论肿瘤大小或切缘状态如何，均无生存获益。
