Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan.
Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan.
Jpn J Clin Oncol. 2023 Dec 7;53(12):1153-1161. doi: 10.1093/jjco/hyad119.
Myxoid liposarcoma is more radiosensitive than other soft tissue sarcomas, and radiotherapy has been reported to reduce tumour size. This study was performed to compare the rates of local recurrence, survival and wound complications between pre- and post-operative radiotherapy for localized myxoid liposarcoma.
From the Japanese Nationwide Bone and Soft Tissue Tumor Registry database, 200 patients with localized myxoid liposarcoma who received pre- (range, 30-56 Gy) or post-operative (range, 45-70 Gy) radiotherapy and surgery were included in this retrospective study. Propensity score matching was used to adjust for background differences between patients who received pre- and post-operative radiotherapy.
Local recurrence occurred in five (5.0%) and nine (9.0%) patients in the pre- and post-operative radiotherapy groups, respectively (both n = 100). The median follow-up time from diagnosis was 40.5 months (IQR, 26.3-74). Univariate analysis showed a similar risk of local recurrence between the pre- and post-operative radiotherapy groups (5-year local recurrence-free survival 94.9% [95% CI 87.0-98.1] vs. 89.0% [95% CI 79.6-94.3]; P = 0.167). Disease-specific survival was similar between the pre- and post-operative radiotherapy groups (5-year disease-specific survival 88.1% [95% CI 75.5-94.6] vs. 88.4% [95% CI 77.3-94.5]; P = 0.900). The incidence of wound complications was similar between the pre- and post-operative radiotherapy groups (7.0% vs. 12.0%; P = 0.228).
There was no difference in local recurrence, survival or incidence of wound complications between pre- and post-operative radiotherapy for localized myxoid liposarcoma. Therefore, pre-operative radiotherapy for myxoid liposarcoma provides clinical results equivalent to post-operative radiotherapy.
黏液样脂肪肉瘤比其他软组织肉瘤更具放射敏感性，放疗已被报道可缩小肿瘤体积。本研究旨在比较局部黏液样脂肪肉瘤术前和术后放疗的局部复发率、生存率和伤口并发症发生率。
从日本全国骨与软组织肿瘤登记数据库中，纳入 200 例接受局部黏液样脂肪肉瘤术前（范围：30-56 Gy）或术后（范围：45-70 Gy）放疗和手术的患者，进行回顾性研究。采用倾向评分匹配法调整两组患者的背景差异。
术前和术后放疗组分别有 5 例（5.0%）和 9 例（9.0%）患者发生局部复发（每组 n=100）。从诊断到随访的中位时间为 40.5 个月（IQR：26.3-74）。单因素分析显示，两组的局部复发风险相似（5 年局部无复发生存率 94.9%[95%CI 87.0-98.1] vs. 89.0%[95%CI 79.6-94.3]；P=0.167）。两组患者的疾病特异性生存率也相似（5 年疾病特异性生存率 88.1%[95%CI 75.5-94.6] vs. 88.4%[95%CI 77.3-94.5]；P=0.900）。两组的伤口并发症发生率也相似（7.0% vs. 12.0%；P=0.228）。
局部黏液样脂肪肉瘤术前和术后放疗的局部复发、生存或伤口并发症发生率无差异。因此，黏液样脂肪肉瘤的术前放疗可提供与术后放疗相当的临床结果。
