Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Transl Oncol. 2021 May;23(5):922-930. doi: 10.1007/s12094-020-02534-0. Epub 2021 Jan 6.
Soft-tissue sarcomas constitute an uncommon and heterogeneous group of tumors of mesenchymal origin. Diagnosis, treatment, and management should be performed by an expert multidisciplinary team. MRI/CT of the primary tumor and biopsy is mandatory before any treatment. Wide surgical resection with tumor-free tissue margin is the mainstay for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not suitable for re-excision. Perioperative chemotherapy should be discussed for high-risk sarcomas of the extremities and trunk-wall. In the case of oligometastatic disease, patients should be considered for local therapies. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. Other drugs have shown activity in second-line therapy and in specific histological subtypes but options are limited and thus, a clinical trial should always be discussed.
软组织肉瘤是一种罕见且异质性的间叶组织来源的肿瘤。诊断、治疗和管理应由专家多学科团队进行。在任何治疗之前,都必须对原发肿瘤进行 MRI/CT 和活检。广泛的肿瘤切缘外科切除术是局限性疾病的主要治疗方法。对于大、深、高级别的肿瘤,或不适合再次切除的边缘性切除术后,应考虑放疗。对于四肢和胸壁高危肉瘤,应讨论围手术期化疗。对于寡转移疾病,应考虑局部治疗。一线治疗方案是使用蒽环类药物(或联合异环磷酰胺)。其他药物在二线治疗和特定组织学亚型中显示出活性,但选择有限,因此应始终讨论临床试验。