Department of Radiotherapy and Radiation Oncology, Public Hospital of Bielefeld, University Medical Center East Westphalia-Lippe, Bielefeld, Germany.
Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Radiat Oncol. 2023 Mar 3;18(1):44. doi: 10.1186/s13014-023-02238-z.
Soft tissue sarcomas (STS) are a relatively rare group of malignant tumors. Currently, there is very little published clinical data, especially in the context of curative multimodal therapy with image-guided, conformal, intensity-modulated radiotherapy.
Patients who received preoperative or postoperative intensity-modulated radiotherapy for STS of the extremities or trunk with curative intent were included in this single centre retrospective analysis. A Kaplan-Meier analysis was performed to evaluate survival endpoints. Multivariable proportional hazard models were used to investigate the association between survival endpoints and tumour-, patient-, and treatment-specific characteristics.
86 patients were included in the analysis. The most common histological subtypes were undifferentiated pleomorphic high-grade sarcoma (UPS) (27) and liposarcoma (22). More than two third of the patients received preoperative radiation therapy (72%). During the follow-up period, 39 patients (45%) suffered from some type of relapse, mainly remote (31%). The two-years overall survival rate was 88%. The median DFS was 48 months and the median DMFS was 51 months. Female gender (HR 0.460 (0.217; 0.973)) and histology of liposarcomas compared to UPS proved to be significantly more favorable in terms of DFS (HR 0.327 (0.126; 0.852)).
Conformal, intensity-modulated radiotherapy is an effective treatment modality in the preoperative or postoperative management of STS. Especially for the prevention of distant metastases, the establishment of modern systemic therapies or multimodal therapy approaches is necessary.
软组织肉瘤（STS）是一组相对罕见的恶性肿瘤。目前，发表的临床数据非常有限，特别是在采用图像引导、适形、调强放疗进行有治愈意图的综合治疗的情况下。
本单中心回顾性分析纳入了接受有治愈意图的肢体或躯干 STS 术前或术后调强放疗的患者。采用 Kaplan-Meier 分析评估生存终点。采用多变量比例风险模型探讨生存终点与肿瘤、患者和治疗特异性特征之间的关系。
86 例患者纳入分析。最常见的组织学亚型为未分化多形性高级别肉瘤（UPS）（27 例）和脂肪肉瘤（22 例）。超过三分之二的患者接受了术前放疗（72%）。在随访期间，39 例（45%）患者出现某种类型的复发，主要为远处（31%）。两年总生存率为 88%。DFS 的中位数为 48 个月，DMFS 的中位数为 51 个月。与 UPS 相比，女性（HR 0.460（0.217；0.973））和脂肪肉瘤的组织学特征在 DFS 方面表现出明显更有利（HR 0.327（0.126；0.852））。
适形、调强放疗是 STS 术前或术后管理的有效治疗方式。特别是为了预防远处转移，有必要建立现代全身治疗或多模式治疗方法。
