O'Sullivan B
Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ont.
Can J Surg. 1988 Nov;31(6):397-403.
Current management of extremity soft-tissue sarcomas achieves local control in a high proportion of patients. This paper describes the local methods to conserve limb function that have largely replaced traditional approaches of ablative surgery. Frequently, these methods employ conservative surgery with preoperative or postoperative radiotherapy. An understanding of the biology and behaviour of these rare tumours is necessary to optimize the goals of limb conservation without compromising local control. Appropriate surgical and radiotherapy techniques are facilitated by planned pretreatment staging methods and communication between the surgical and radiation oncology teams. Although a high rate of local control can be expected, distant metastases continue to be a problem. Future strategies should be directed towards scheduling of optimal local treatments with the investigation of adjuvant systemic methods to reduce the rate of distant metastases.
目前，肢体软组织肉瘤的治疗方法在很大比例的患者中实现了局部控制。本文描述了在很大程度上已取代传统根治性手术方法的保留肢体功能的局部治疗方法。通常，这些方法采用术前或术后放疗的保肢手术。了解这些罕见肿瘤的生物学特性和行为对于在不影响局部控制的情况下优化保肢目标至关重要。计划好的治疗前分期方法以及外科和放射肿瘤学团队之间的沟通有助于采用适当的手术和放疗技术。尽管可以预期局部控制率较高，但远处转移仍然是一个问题。未来的策略应着眼于安排最佳的局部治疗，并研究辅助性全身治疗方法以降低远处转移率。
