Di Xuemin, Liang Yansong, Yu Huimin, Zhao Jinxin, Wang Zeyang, Zhao Jing, Sui Aixia, Zhang Hongtao, Wang Juan
Department of Oncology, The Hebei General Hospital, Shijiazhuang, Hebei Province, China.
J Cancer Res Ther. 2020;16(2):397-400. doi: 10.4103/jcrt.JCRT_66_18.
Retroperitoneal leiomyosarcoma is relatively uncommon. Leiomyosarcoma has accounted for about 5%-10% of soft-tissue sarcoma, and 1/2-2/3 of the primary lesions were retroperitoneal, with a cumulative 5-year survival rate of only 35%.Leiomyosarcoma is one kind of soft-tissue sarcoma with the lowest survival rates due to the invasive growth, difficult treatment, and poor prognosis.The present study reported a case of a 78-year-old male diagnosed as left retroperitoneal leiomyosarcoma, who had received three operations. Computed tomography (CT) demonstrated a mass of approximately 12.9 cm × 6.9 cm × 6.6 cm in his retroperitoneal region. The Eastern cooperative oncology group and numerical rating scale scores of pain were 1 and 5, respectively. Multiple treatment strategies were administered, including the application of drainage andI seed implantation. A total of 90I seeds were implanted into the tumor through repetitious operations, with 30 seeds each time. Treatment planning system was involved to calculate the source distribution.I seeds with the activity of 0.5 mCi were implanted under the guidance of CT, and dosimetric verification was performed after the operation. D90 (90% minimum prescription dose received by target volume) was 40 Gy. Follow-up was performed after 6 months, and complete response was achieved in the local lesions. However, there was no evidence-based treatment currently and the majority of our knowledge was based on results from case reports, thus further studies would be required.
腹膜后平滑肌肉瘤相对少见。平滑肌肉瘤约占软组织肉瘤的5%-10%，其中1/2-2/3的原发灶位于腹膜后，其5年累计生存率仅为35%。由于其呈浸润性生长、治疗困难且预后较差，平滑肌肉瘤是生存率最低的软组织肉瘤之一。本研究报告了1例78岁男性患者，诊断为左腹膜后平滑肌肉瘤，已接受3次手术。计算机断层扫描（CT）显示其腹膜后区域有一个大小约为12.9 cm×6.9 cm×6.6 cm的肿块。东部肿瘤协作组（ECOG）评分和疼痛数字评分量表评分分别为1分和5分。采用了多种治疗策略，包括引流和碘粒子植入。通过多次手术共向肿瘤植入90颗碘粒子，每次植入30颗。利用治疗计划系统计算粒子分布。在CT引导下植入活度为0.5 mCi的碘粒子，术后进行剂量验证。D90（靶区接受的90%最小处方剂量）为40 Gy。6个月后进行随访，局部病灶达到完全缓解。然而，目前尚无循证治疗方案，我们的大部分认知基于病例报告结果，因此需要进一步研究。
