Tween Hannah, Peake David, Spooner David, Sherriff Jenny
Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK.
Healthcare (Basel). 2019 Oct 18;7(4):120. doi: 10.3390/healthcare7040120.
Sarcomas are rare and heterogeneous tumours with a large proportion of patients requiring palliative intervention. They are regarded as relatively radioresistant and therefore achieving good palliation with radiation may require larger doses than for more common solid tumour types. Limited data is available regarding appropriate palliative radiotherapy dose fractionation. This case series aims to assess the effectiveness of radiotherapy in providing symptomatic improvement for advanced sarcomas. : Data was retrospectively collected for patients treated with palliative radiotherapy between July 2010 and April 2019 at one institution. The primary outcome was documented symptomatic improvement following radiotherapy. Secondary outcome was overall survival. : One hundred and five patients had a total of 137 sites treated using 25 different dose fractionation schedules. The median patient age was 54 (range 8-90) years. Treated sites included 114 soft tissue and 23 bone sarcomas. Data on symptomatic improvement was available in 56% and 67% of cases respectively. A total of 70% of soft tissue and 55% of bone sarcoma patients reported symptomatic improvement. Symptomatic response rates appeared to increase to a biological effective dose (BED) of 50Grey (Gy) (alpha beta ratio (α/β) = 4 for tumour) but did not continue to improve with further rises in dose beyond this. : Palliative radiotherapy offers symptomatic improvement for sarcoma patients with two-thirds of patients reporting reduction in symptoms. These results are limited by the heterogeneous study population including different sarcoma subtypes each with a probable different radio-sensitivity, treated with different radiotherapy schedules. Further prospective data collection is needed considering sarcoma subtype radio-sensitivity, to determine appropriate palliative dose fractionation schedules.
肉瘤是罕见且异质性的肿瘤，大部分患者需要姑息治疗。它们被认为相对抗拒放疗，因此与更常见的实体瘤类型相比，要实现良好的姑息治疗效果可能需要更高的剂量。关于合适的姑息性放疗剂量分割的可用数据有限。本病例系列旨在评估放疗对晚期肉瘤患者症状改善的有效性。：回顾性收集了2010年7月至2019年4月在一家机构接受姑息性放疗的患者的数据。主要结局是记录放疗后症状的改善情况。次要结局是总生存期。：105例患者共137个部位接受了治疗，采用了25种不同的剂量分割方案。患者的中位年龄为54岁（范围8 - 90岁）。治疗部位包括114例软组织肉瘤和23例骨肉瘤。分别有56%和67%的病例有症状改善的数据。总共70%的软组织肉瘤患者和55%的骨肉瘤患者报告症状有所改善。症状缓解率似乎在生物等效剂量（BED）达到50格雷（Gy）（肿瘤的α/β比值 = 4）时有所上升，但超过此剂量后继续增加剂量并未进一步改善。：姑息性放疗能使肉瘤患者的症状得到改善，三分之二的患者报告症状减轻。这些结果受到研究人群异质性的限制，包括不同的肉瘤亚型，每种亚型可能具有不同的放射敏感性，且采用了不同的放疗方案。考虑到肉瘤亚型的放射敏感性，需要进一步进行前瞻性数据收集，以确定合适的姑息性剂量分割方案。
