Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center Houston, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Health Services Research, The University of Texas MD Anderson Cancer Center Houston, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Curr Oncol Rep. 2020 Jun 29;22(8):79. doi: 10.1007/s11912-020-00936-5.
The management of metastatic disease is evolving. As systemic therapies continue to improve, there is increasing recognition that local therapy to distant sites of disease impacts outcomes among many histologies, including sarcoma. Various local therapy strategies exist, but radiation therapy (RT) is particularly critical as it provides a non-invasive, yet locally ablative strategy for metastatic management.
Various delivery techniques including stereotactic body radiation therapy (SBRT) or hypofractionated RT can escalate the biologic dose while avoiding normal tissues in order to reduce tumor burden, provide durable local control, palliate symptoms, potentially prevent further seeding of metastatic lesions, and potentially prolong survival. This review summarizes the current state of the literature on the important role of RT for the treatment of metastatic sarcoma organized by the site of metastatic disease. Particularly for patients presenting with oligometastatic or oligoprogressive disease, consolidative RT is an important local therapy strategy to be considered in a multidisciplinary setting.
转移性疾病的治疗正在不断发展。随着系统治疗的不断进步，人们越来越认识到，针对远处疾病部位的局部治疗对包括肉瘤在内的多种组织学的结局有影响。存在各种局部治疗策略，但放射治疗（RT）尤为关键，因为它为转移性疾病的管理提供了一种非侵入性但局部消融的策略。
包括立体定向体部放射治疗（SBRT）或低分割放疗在内的各种传递技术可以在避免正常组织的情况下提高生物剂量，以减少肿瘤负担、提供持久的局部控制、缓解症状、潜在地防止转移病灶的进一步播散，并可能延长生存时间。本综述通过转移性疾病的部位对 RT 治疗转移性肉瘤的重要作用的现有文献进行了总结。对于表现为寡转移或寡进展性疾病的患者，巩固性 RT 是一种重要的局部治疗策略，应在多学科环境中进行考虑。
