Callaghan Cameron M, Hasibuzzaman M M, Rodman Samuel N, Goetz Jessica E, Mapuskar Kranti A, Petronek Michael S, Steinbach Emily J, Miller Benjamin J, Pulliam Casey F, Coleman Mitchell C, Monga Varun V, Milhem Mohammed M, Spitz Douglas R, Allen Bryan G
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA 52422, USA.
Holden Comprehensive Cancer Center and Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52422, USA.
Cancers (Basel). 2020 Aug 12;12(8):2258. doi: 10.3390/cancers12082258.
Historically, patients with localized soft tissue sarcomas (STS) of the extremities would undergo limb amputation. It was subsequently determined that the addition of radiation therapy (RT) delivered prior to (neoadjuvant) or after (adjuvant) a limb-sparing surgical resection yielded equivalent survival outcomes to amputation in appropriate patients. Generally, neoadjuvant radiation offers decreased volume and dose of high-intensity radiation to normal tissue and increased chance of achieving negative surgical margins-but also increases wound healing complications when compared to adjuvant radiotherapy. This review elaborates on the current neoadjuvant/adjuvant RT approaches, wound healing complications in STS, and the potential application of novel radioprotective agents to minimize radiation-induced normal tissue toxicity.
从历史上看，患有四肢局限性软组织肉瘤（STS）的患者会接受肢体截肢手术。随后确定，在保肢手术切除之前（新辅助）或之后（辅助）进行放射治疗（RT），在合适的患者中可产生与截肢相当的生存结果。一般来说，新辅助放疗可减少对正常组织的高强度辐射体积和剂量，并增加实现手术切缘阴性的机会，但与辅助放疗相比，也会增加伤口愈合并发症。本综述阐述了当前的新辅助/辅助放疗方法、STS中的伤口愈合并发症，以及新型放射防护剂在最小化辐射诱导的正常组织毒性方面的潜在应用。
