Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Eur J Orthop Surg Traumatol. 2021 Dec;31(8):1583-1596. doi: 10.1007/s00590-021-02990-6. Epub 2021 May 6.
Local management of adult soft tissue sarcoma of the extremities has evolved over the past decades. Until the 1970s, radical surgery (amputations) was the standard therapeutic procedure resulting in significant physical and psychological morbidity for the patients. In the present era, limb sparing surgery combined with radiotherapy represents the current standard of care for high grade and > 5 cm STSs. This approach guarantees high local control rate and function preservation. The aim of this paper is to summarize the current evidence for RT in STSs of the extremities. Outcomes, technical details (techniques, timing, dose, volumes of treatment) and the emerging role of RT in the management of oligometastatic disease will be analysed. Finally, results of the recent clinical trials testing new scenarios in RT of STSs will be described.
在过去几十年中,四肢成人软组织肉瘤的局部治疗方法已经发生了演变。直到 20 世纪 70 年代,激进的手术(截肢)仍是标准的治疗方法,这给患者带来了显著的身体和心理上的发病率。在当今时代,保肢手术联合放疗是高级别和> 5 cm STS 的当前治疗标准。这种方法可保证高局部控制率和功能保留。本文旨在总结当前 RT 在四肢软组织肉瘤中的证据。将分析治疗结果、技术细节(技术、时机、剂量、治疗体积)以及 RT 在寡转移疾病治疗中的新作用。最后,将描述最近测试 STS 中 RT 新方案的临床试验结果。