Raz Dan J, Clancy Sharon L, Erhunmwunsee Loretta J
Division of Thoracic Surgery, City of Hope, MOB 2001B, 1500 East Duarte Road, Duarte, CA 91010, USA.
Division of Plastic Surgery, City of Hope, MOB 2001B, 1500 East Duarte Road, Duarte, CA 91010, USA.
Thorac Surg Clin. 2017 May;27(2):171-179. doi: 10.1016/j.thorsurg.2017.01.011. Epub 2017 Mar 1.
Radiation to the chest wall is common before resection of tumors. Osteoradionecrosis can occur after radiation treatment. Radical resection and reconstruction can be lifesaving. Soft tissue coverage using myocutaneous or omental flaps is determined by the quality of soft tissue available and the status of the vascular pedicle supplying available myocutaneous flaps. Radiation-induced sarcomas of the chest wall occur most commonly after radiation therapy for breast cancer. Although angiosarcomas are the most common radiation-induced sarcomas, osteosarcoma, myosarcomas, rhabdomyosarcoma, and undifferentiated sarcomas also occur. The most effective treatment is surgical resection. Inoperable tumors are treated with chemotherapy, with low response rates.
在肿瘤切除术前，胸部放疗很常见。放疗后可能会发生骨放射性坏死。根治性切除和重建可能挽救生命。使用肌皮瓣或网膜瓣进行软组织覆盖取决于可用软组织的质量以及供应可用肌皮瓣的血管蒂状况。胸壁放射性肉瘤最常发生于乳腺癌放疗后。虽然血管肉瘤是最常见的放射性肉瘤，但骨肉瘤、肌肉肉瘤、横纹肌肉瘤和未分化肉瘤也会出现。最有效的治疗方法是手术切除。无法手术的肿瘤采用化疗，缓解率较低。
