Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Département d'oncologie radiothérapie, Institut régional du cancer Montpellier (ICM), université de Montpellier, rue Croix-Verte, 34070 Montpellier, France.
Cancer Radiother. 2022 Feb-Apr;26(1-2):377-387. doi: 10.1016/j.canrad.2021.11.023. Epub 2021 Dec 24.
We present the update of the recommendations of the French society of radiation oncology on soft tissue sarcomas. Currently, the initial management of sarcomas is very important as it may impact on patients' quality of life, especially in limb soft tissue sarcomas, and on overall survival in trunk sarcomas. Radiotherapy has to be discussed within a multidisciplinary board meeting with results of biopsy, eventually reexamined by a dedicated sarcoma pathologist. The role of radiotherapy varies according to localization of soft tissue sarcoma. It is part of the standard treatment in grade 2 and 3 sarcomas of the extremities and superficial trunk>5cm. In case of R1 or R2 resection, reexcision should be discussed. In such cases, it may be delivered preoperatively (50Gy/25 fractions of 2Gy) or postoperatively. In retroperitoneal sarcomas, preoperative conformal radiotherapy with or without modulated intensity cannot be proposed systematically in daily practice. Concomitant chemoradiotherapy cannot be considered a standard treatment. Intensity-modulated radiotherapy has become widely available. Other soft tissue sarcoma sites such as trunk, head and neck and gynaecological soft tissue sarcomas will be addressed, as well as other techniques that may be used such as brachytherapy and proton therapy.
我们提出了法国放射肿瘤学会关于软组织肉瘤的建议更新。目前，肉瘤的初始治疗非常重要，因为它可能会影响患者的生活质量，尤其是在肢体软组织肉瘤中，并且会影响躯干肉瘤的总生存率。放疗必须在多学科委员会会议上进行讨论，会议要结合活检结果，最终由专门的肉瘤病理学家进行重新检查。放疗的作用因软组织肉瘤的位置而异。它是四肢和浅表躯干>5cm 的 2 级和 3 级肉瘤的标准治疗的一部分。如果切除范围为 R1 或 R2，则应讨论再次切除。在这种情况下，可以术前（50Gy/25 次，每次 2Gy）或术后进行。在腹膜后肉瘤中，术前常规的调强放疗或不调强放疗在日常实践中不能系统地进行。同期放化疗不能被认为是标准治疗。调强放疗已广泛应用。还将讨论其他软组织肉瘤部位，如躯干、头颈部和妇科软组织肉瘤，以及可能使用的其他技术，如近距离放疗和质子治疗。
