Llacer-Moscardo C, Bourgier C, Morel A, Fenoglietto P, Carrère S, Firmin N, Azria D
Département de radiothérapie oncologique, institut du cancer de Montpellier (ICM), 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 5, France.
Département de radiothérapie oncologique, institut du cancer de Montpellier (ICM), 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 5, France.
Cancer Radiother. 2016 Oct;20(6-7):666-76. doi: 10.1016/j.canrad.2016.07.074. Epub 2016 Sep 7.
The standard treatment for extremity soft tissue sarcomas is based on the association of surgery and radiotherapy. This strategy allows local control improvement with the risk of increased toxicity. There is therefore a growing interest to identify those patients who will benefit from radiotherapy and those who will have the same local control with surgery alone. Furthermore, the development of toxicity has been correlated with the extension of the irradiated volume and the volume receiving high doses. Technological development as intensity modulated radiotherapy and image-guided radiotherapy allows limited irradiated volume improving the protection of the organs at risk leading to clinical benefit improvement. Moreover, efforts are being done to improve local control for the patients at high risk of local relapse. In this paper, we discuss all these mentioned aspects.
肢体软组织肉瘤的标准治疗基于手术和放疗相结合。这种策略可改善局部控制,但存在毒性增加的风险。因此,越来越需要确定哪些患者将从放疗中获益,哪些患者仅通过手术就能获得相同的局部控制。此外,毒性的发生与照射体积的大小以及接受高剂量照射的体积有关。像调强放疗和图像引导放疗等技术的发展,使得照射体积受限,从而改善了对危及器官的保护,带来了临床获益的提升。此外,人们正在努力改善局部复发高危患者的局部控制。在本文中,我们将讨论上述所有方面。