Lee Hong Seok, Yu Jeong Il, Lim Do Hoon, Kim Sung Joo
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Radiat Oncol J. 2016 Sep;34(3):216-222. doi: 10.3857/roj.2016.01858. Epub 2016 Sep 28.
To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal.
We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169).
Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087).
RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.
评估在大体肿瘤切除术后辅助放疗（RT）对腹膜后脂肪肉瘤（RPLS）的益处。
我们回顾了2000年1月至2013年12月期间接受手术治疗的77例原发性RPLS患者。排除有大体残留病灶的病例。根据法国癌症中心肉瘤组（FNCLCC）系统评估肿瘤分级。32例患者（42%）仅接受了外照射放疗作为辅助RT。中位随访时间为36个月（范围5至169个月）。
77例患者中，33例（43%）为高分化型，31例（40%）为去分化型，8例（10%）为黏液样/圆形，4例（5%）为多形性形态。放疗组中高分化亚型的比例低于手术组（28%对53%）。随访期间，34例患者（44%）出现局部复发。放疗组的局部复发率（38%）低于手术组（49%）。3年局部控制率（LC）为55.6%，3年总生存率（OS）为82.1%。肿瘤组织学和FNCLCC分级与局部复发显著相关。在局部控制方面添加辅助放疗无统计学意义（p = 0.312）。然而，除高分化亚型外的肿瘤组织学类型患者在辅助放疗后局部复发率略有降低（3年LC，放疗组43.9%对未放疗组35.3%；p = 0.087）。
接受放疗的RPLS患者局部复发较少。我们建议添加辅助放疗可能与局部控制的改善有关，特别是在组织学亚型不佳的患者中。
