头颈部成人软组织肉瘤的放射治疗。

Radiotherapy for Adult Soft Tissue Sarcomas of the Head and Neck.

机构信息

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL.

出版信息

Am J Clin Oncol. 2020 Sep;43(9):667-669. doi: 10.1097/COC.0000000000000729.

DOI:10.1097/COC.0000000000000729

PMID:32889838

Abstract

OBJECTIVE

Surgery followed by postoperative radiation therapy (RT) is the standard of care for soft tissue sarcomas (STS) of the head and neck that are high grade or have close or positive margins.

METHODS

The authors retrospectively reviewed adult patients with head and neck STS treated with RT at a single institution between 1981 and 2017. All patients who were 19 years and older with STS of the head and neck-excluding rhabdomyosarcoma, angiosarcoma, and Ewing tumors-were included in this study. Toxicity was graded using Common Terminology Criteria for Adverse Events (CTCAE), version 4.

RESULTS

Among 34 patients with head and neck STS treated with postoperative RT (33) or primary RT (1) who met the inclusion criteria, the median age at diagnosis was 45 years (range, 20 to 83). Overall, 37% had T1 tumors, 50% had high-grade histology (grade 3), and 26% had microscopically positive margins. The median RT dose was 65 Gy to the primary site; 29% received elective nodal irradiation. The median follow-up for living patients was 16.6 years (range, 0.6 to 30). At 5 and 10 years, the local control rates were 88% and 80%, the regional control rates were 97% and 97%, the freedom from distant metastases rates were 100% and 100%, the cause-specific survival rates were 88% and 81%, and the overall survival rates were 85% and 69%. Two patients (6%) developed late grade 3+ complications.

CONCLUSION

Our study demonstrates that surgery and radiotherapy for STS of the head and neck have excellent disease outcomes.

摘要

目的

对于高级别或切缘接近或阳性的头颈部软组织肉瘤（STS），手术联合术后放疗（RT）是标准治疗方法。

方法

作者回顾性分析了 1981 年至 2017 年期间在单一机构接受 RT 治疗的头颈部 STS 成年患者。本研究纳入了头颈部 STS 患者，排除横纹肌肉瘤、血管肉瘤和尤文氏瘤，年龄均在 19 岁及以上。毒性分级采用不良事件通用术语标准（CTCAE）第 4 版。

结果

在 34 名符合纳入标准的接受术后 RT（33 例）或原发 RT（1 例）治疗的头颈部 STS 患者中，诊断时的中位年龄为 45 岁（范围：20-83 岁）。总体而言，37%的患者肿瘤 T1 期，50%的患者组织学分级高（3 级），26%的患者切缘显微镜下阳性。原发部位 RT 剂量中位数为 65Gy；29%的患者行选择性淋巴结照射。存活患者的中位随访时间为 16.6 年（范围：0.6-30 年）。5 年和 10 年时，局部控制率分别为 88%和 80%，区域控制率分别为 97%和 97%，无远处转移率分别为 100%和 100%，特异性生存率分别为 88%和 81%，总生存率分别为 85%和 69%。2 例患者（6%）发生迟发性 3+级并发症。