Yu Jeong Il, Lim DO Hoon, Park Hee Chul, Jung Sang Hoon, Jeon Seong Jin, Nam Heerim, Kim Bokyoung, Kim Sung-Joo, Park Jae Berm
Department of Radiation Oncology, Samsung Medical Center, Seoul, Republic of Korea.
Department of Radiation Oncology, Samsung Medical Center, Seoul, Republic of Korea
Anticancer Res. 2018 Apr;38(4):2447-2453. doi: 10.21873/anticanres.12498.
BACKGROUND/AIM: We investigated the effectiveness and safety of using a tissue expander (TE) for adjuvant helical tomotherapy (HT) for curatively resected retroperitoneal sarcoma (RPS).
This study was conducted with 60 RPS patients who underwent curative resection with or without TE insertion followed by HT from June 2009 to December 2016. Among the patients, TE was inserted in 37 (61.7%). The quality of TE insertion was evaluated. Median follow-up after surgery was 19.4 months (range=4.5-93.2 months).
A higher biologically-equivalent dose (α/β=10) was used with patients who had TE insertion (median, 72.0 gray [Gy] vs. 67.1 Gy, p=0.02). The quality of TE insertion was excellent in 18 patients (48.6%), good in 10 (27.0%), fair in seven (18.9%), and poor in two (5.4%). Toxicity was not significantly different according to TE insertion. Local recurrence-free survival (LRFS) was 78.2%, and overall survival was 95.6% at 3 years. TE insertion was not a significant factor for LRFS (91.1% in TE vs. 62.9% in non-TE group at 3 years, p=0.62). In the subgroup of patients with R1 or unknown tumor margin status, however, LRFS was marginally higher in the TE insertion group (100.0% in TE vs. 62.9% non-TE group at 3 years, p=0.05).
HT with TE insertion as adjuvant RT for curatively resected RPS was feasible with acceptable toxicity. In the patients with R1 or unknown tumor margin status, LRFS was marginally higher in the TE insertion group after HT.
背景/目的：我们研究了在接受根治性切除的腹膜后肉瘤（RPS）辅助螺旋断层放疗（HT）中使用组织扩张器（TE）的有效性和安全性。
本研究纳入了60例接受根治性切除的RPS患者，这些患者于2009年6月至2016年12月期间接受了HT治疗，其中部分患者在手术中植入了TE。60例患者中，37例（61.7%）植入了TE。评估了TE植入的质量。术后中位随访时间为19.4个月（范围=4.5 - 93.2个月）。
植入TE的患者使用了更高的生物等效剂量（α/β = 10）（中位剂量，72.0格雷[Gy] 对比67.1 Gy，p = 0.02）。18例患者（48.6%）的TE植入质量为优，10例（27.0%）为良，7例（18.9%）为中，2例（5.4%）为差。根据TE植入情况，毒性无显著差异。3年时局部无复发生存率（LRFS）为78.2%，总生存率为95.6%。TE植入不是LRFS的显著影响因素（3年时TE组为91.1%，非TE组为62.9%，p = 0.62）。然而，在R1或肿瘤切缘状态未知的亚组患者中，TE植入组的LRFS略高（3年时TE组为100.0%，非TE组为62.9%，p = 0.05）。
对于接受根治性切除的RPS患者，植入TE的HT作为辅助放疗是可行的，毒性可接受。在R1或肿瘤切缘状态未知的患者中，HT后TE植入组的LRFS略高。
