Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Building 10 CCR, Room B2-3500, Bethesda, MD 20892, USA.
Surg Clin North Am. 2022 Aug;102(4):567-582. doi: 10.1016/j.suc.2022.04.001. Epub 2022 Jun 24.
Radiation therapy is an integral component of local management with oncologic resection for soft tissue sarcoma. Radiotherapy is indicated in patients at an increased risk of local recurrence so that improved local control may be achieved. Sequencing of radiotherapy and resection should be determined by multidisciplinary input before treatment initiation. For most patients, preoperative delivery of radiation therapy is preferred. In patients initially thought to be at low risk for local recurrence and found to have unexpected adverse pathologic features at resection, postoperative radiation therapy is indicated. The use of radiation therapy for retroperitoneal sarcoma is controversial; when used, preoperative delivery of radiation is recommended.
放射治疗是软组织肉瘤肿瘤切除术后局部管理的一个组成部分。对于局部复发风险增加的患者,应进行放射治疗,以实现更好的局部控制。在开始治疗之前,应通过多学科意见确定放射治疗和切除术的顺序。对于大多数患者,术前给予放射治疗是首选。对于最初认为局部复发风险低的患者,如果在切除时发现具有意外的不良病理特征,则应进行术后放射治疗。对于腹膜后肉瘤使用放射治疗存在争议;当使用放射治疗时,建议术前给予放射治疗。