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碳离子放疗治疗老年骨肉瘤及软组织肉瘤的疗效。

Effectiveness of Carbon Ion Radiotherapy for Bone and Soft Tissue Sarcoma in Older Patients.

机构信息

Department of Orthopedic Surgery, Chiba Cancer Center, Chiba, Japan.

National Institutes for Quantum Science and Technology, QST Hospital, Chiba, Japan.

出版信息

Anticancer Res. 2024 Apr;44(4):1773-1780. doi: 10.21873/anticanres.16977.

Abstract

BACKGROUND/AIM: The aging population is expected to increase the occurrences of bone sarcoma (BS) and soft tissue sarcoma (STS). Carbon ion radiotherapy (CIRT) is reported to be effective for BS and several STSs. However, the effect of CIRT on clinical outcomes, functional prognoses, and quality of life (QOL) in older patients who underwent CIRT has not been reported. Therefore, we aimed to evaluate the effect of CIRT on clinical outcomes, functional prognoses and QOL in older patients with BS or STS.

PATIENTS AND METHODS

This retrospective cohort study included 235 patients aged >70 years with BS or STS who underwent CIRT. Overall survival (OS), cancer-specific survival (CSS), and local control (LC) were evaluated in chordoma and non-chordoma patients. Furthermore, factors associated with post-CIRT Toronto Extremity Salvage Score (TESS) and EuroQoL 5-dimension 5-level (EQ-5D-5L) index were assessed.

RESULTS

The overall 5-year LC, OS, and CSS rates were 81%, 62%, and 76%, respectively. In the chordoma and non-chordoma groups, the 5-year LC, OS, and CSS rates were 84%, 72%, and 87%; and 77%, 47%, and 60%, respectively. The mean post-CIRT TESS and EQ-5D-5L index were 75% and 0.71, respectively. The TESSs and EQ-5D-5L indices tended to be better among males, younger patients (<76 years old), patients with small tumor volumes, and patients with chordoma.

CONCLUSION

CIRT is effective for older patients with BS, especially with chordoma, and STS with good LC and survival rates. Furthermore, post-treatment limb function and QOL were comparable with those of the other treatments and age groups.

摘要

背景/目的:预计人口老龄化将增加骨肉瘤(BS)和软组织肉瘤(STS)的发病率。碳离子放疗(CIRT)已被报道对 BS 和几种 STS 有效。然而,对于接受 CIRT 的老年患者,CIRT 对临床结果、功能预后和生活质量(QOL)的影响尚未报道。因此,我们旨在评估 CIRT 对 BS 或 STS 老年患者的临床结果、功能预后和 QOL 的影响。

患者和方法

这项回顾性队列研究纳入了 235 名年龄>70 岁的接受 CIRT 的 BS 或 STS 患者。在软骨肉瘤和非软骨肉瘤患者中评估了总生存率(OS)、癌症特异性生存率(CSS)和局部控制率(LC)。此外,还评估了与 CIRT 后多伦多肢体挽救评分(TESS)和欧洲五维健康量表 5 级(EQ-5D-5L)指数相关的因素。

结果

总体 5 年 LC、OS 和 CSS 率分别为 81%、62%和 76%。在软骨肉瘤和非软骨肉瘤组中,5 年 LC、OS 和 CSS 率分别为 84%、72%和 87%;77%、47%和 60%。CIRT 后 TESS 和 EQ-5D-5L 指数的平均值分别为 75%和 0.71。男性、年龄较小(<76 岁)、肿瘤体积较小、软骨肉瘤患者的 TESS 和 EQ-5D-5L 指数倾向于更好。

结论

CIRT 对 BS,尤其是软骨肉瘤和 STS 老年患者有效,可获得良好的 LC 和生存率。此外,治疗后肢体功能和 QOL 与其他治疗方法和年龄组相当。

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