Laskin W B, Silverman T A, Enzinger F M
Department of Soft Tissue Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306.
Cancer. 1988 Dec 1;62(11):2330-40. doi: 10.1002/1097-0142(19881201)62:11<2330::aid-cncr2820621113>3.0.co;2-2.
The clinicopathologic features of 53 cases of postradiation soft tissue sarcoma (PRS) were correlated with the physical characteristics of the administered radiation. All but three patients received radiation for malignant processes. Of the secondary sarcomas, malignant fibrous histiocytoma (MFH) accounted for 36 cases (68%), followed by seven extraskeletal osteosarcomas (13%), six fibrosarcomas (11%), two malignant Schwannomas (4%), one extraskeletal chondrosarcoma, and one angiosarcoma. The sex incidence, age of the patient at time of diagnosis, and location of the PRS correlated only with the clinical characteristics of the initial treated condition. The latency period (mean 10 years) showed an indefinite relationship to patient survival but no definite relationship to the patient's age at the time of the initial radiation. There was no difference between patients treated with megavoltage radiation (39 patients) and with orthovoltage radiation (seven patients) in the type of sarcoma, location, or survival, although the orthovoltage group received a lower mean radiation dose (3880 rads) than the megavoltage group (4446 rads). Megavoltage radiation, however, produced deeper tissue radiation changes and was associated with a shorter latency period. Most PRS were poorly differentiated, produced abundant collagen, and had a dismal prognosis.
53例放射后软组织肉瘤（PRS）的临床病理特征与所给予放射治疗的物理特性相关。除3例患者外，其余均因恶性疾病接受放疗。在继发性肉瘤中，恶性纤维组织细胞瘤（MFH）占36例（68%），其次是7例骨外骨肉瘤（13%）、6例纤维肉瘤（11%）、2例恶性施万细胞瘤（4%）、1例骨外软骨肉瘤和1例血管肉瘤。PRS的性别发病率、诊断时患者的年龄以及发病部位仅与初始治疗疾病的临床特征相关。潜伏期（平均10年）与患者生存率的关系不明确，但与初始放疗时患者的年龄没有明确关系。在肉瘤类型、发病部位或生存率方面，接受兆伏级放疗的患者（39例）和接受千伏级放疗的患者（7例）之间没有差异，尽管千伏级放疗组的平均放射剂量（3880拉德）低于兆伏级放疗组（4446拉德）。然而，兆伏级放疗会使更深层组织发生放射改变，且潜伏期较短。大多数PRS分化不良，产生大量胶原，预后不佳。
