Department of Medical Oncology, Institut Bergonié, Bordeaux, France; University of Bordeaux, Faculty of Médicine, Bordeaux, France.
University of Bordeaux, Faculty of Médicine, Bordeaux, France; Department of Radiotherapy, Institut Bergonié, Bordeaux, France.
Int J Radiat Oncol Biol Phys. 2019 Feb 1;103(2):449-452. doi: 10.1016/j.ijrobp.2018.09.028. Epub 2018 Oct 5.
Radiation therapy is used as a radical treatment for many cancers and is delivered in the neoadjuvant or adjuvant setting, frequently combined with other treatment modalities such as chemotherapy and surgery. However, radiation exposure is a well established risk factor for developing secondary malignancies. Soft-tissue sarcomas are the most common types of radiation-induced tumors in the general population.
We have analyzed 510 patients from the French Sarcoma Group database. Prognostic factors for locoregional-free Survival (LRFS), metastases-free survival (MFS), and overall Survival (OS) were identified by univariate and multivariate analyses using a Cox regression model.
Median overall survival for patients M0 with R0/R1 surgery was 65.1 months (95% CI, 50.0-98.4). The 5-year and 10-year OS rates were 52.9% (47.1-58.2) and 41.0% (34.2-47.7), respectively. On multivariate analysis, the predictors of worse OS were age, R1 margin status, grade 3 and size >55 mm.
We report here the largest series of patients with radiation-induced soft-tissue sarcomas. We demonstrate that a majority of patients can be cured provided they are managed with adequate surgery.
放射治疗被用作许多癌症的根治性治疗方法，在新辅助或辅助治疗环境中进行，通常与化疗和手术等其他治疗方式联合使用。然而，辐射暴露是引发继发性恶性肿瘤的一个既定风险因素。软组织肉瘤是普通人群中最常见的放射诱导肿瘤类型。
我们分析了法国肉瘤组数据库中的 510 名患者。通过 Cox 回归模型的单因素和多因素分析，确定了局部区域无复发生存（LRFS）、无转移生存（MFS）和总生存（OS）的预后因素。
RO/R1 手术后 M0 患者的中位总生存期为 65.1 个月（95%CI，50.0-98.4）。5 年和 10 年 OS 率分别为 52.9%（47.1-58.2）和 41.0%（34.2-47.7）。多因素分析显示，OS 较差的预测因素是年龄、R1 切缘状态、3 级和肿瘤大小>55mm。
我们在此报告了最大系列的放射诱导软组织肉瘤患者。我们证明，只要患者接受适当的手术治疗，大多数患者都可以治愈。
