骨盆骨肉瘤手术治疗与粒子束治疗的临床疗效比较：日本一项回顾性多中心研究

Comparison of clinical outcome between surgical treatment and particle beam therapy for pelvic bone sarcomas: A retrospective multicenter study in Japan.

作者信息

Takemori Toshiyuki, Hara Hitomi, Kawamoto Teruya, Fukase Naomasa, Sawada Ryoko, Fujiwara Shuichi, Fujita Ikuo, Fujimoto Takuya, Morishita Masayuki, Yahiro Shunsuke, Miyamoto Tomohiro, Saito Masanori, Sugaya Jun, Hayashi Katsuhiro, Kawashima Hiroyuki, Torigoe Tomoaki, Nakamura Tomoki, Kondo Hiroya, Wakamatsu Toru, Watanuki Munenori, Kito Munehisa, Tsukushi Satoshi, Nagano Akihito, Outani Hidetatsu, Toki Shunichi, Nishimura Shunji, Kobayashi Hiroshi, Watanabe Itsuo, Demizu Yusuke, Sasaki Ryohei, Fukumoto Takumi, Matsumoto Tomoyuki, Kuroda Ryosuke, Akisue Toshihiro

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-8558, Japan.

Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan.

出版信息

J Orthop Sci. 2025 May;30(3):523-528. doi: 10.1016/j.jos.2024.06.007. Epub 2024 Jul 3.

DOI:10.1016/j.jos.2024.06.007

PMID:38964957

Abstract

BACKGROUND

Few studies have compared the clinical outcomes of patients with pelvic bone sarcomas treated surgically and those treated with particle beam therapy. This is a multicenter retrospective cohort study which compared the clinical outcomes of patients with pelvic bone sarcoma who underwent surgical treatment and particle beam therapy in Japan.

METHODS

A total of 116 patients with pelvic bone sarcoma treated at 19 specialized sarcoma centers in Japan were included in this study. Fifty-seven patients underwent surgery (surgery group), and 59 patients underwent particle beam therapy (particle beam group; carbon-ion radiotherapy: 55 patients, proton: four patients).

RESULTS

The median age at primary tumor diagnosis was 52 years in the surgery group and 66 years in the particle beam group (P < 0.001), and the median tumor size was 9 cm in the surgery group and 8 cm in the particle beam group (P = 0.091). Overall survival (OS), local control (LC), and metastasis-free survival (MFS) rates were evaluated using the Kaplan-Meier method and compared among 116 patients with bone sarcoma (surgery group, 57 patients; particle beam group, 59 patients). After propensity score matching, the 3-year OS, LC, and MFS rates were 82.9% (95% confidence interval [CI], 60.5-93.2%), 66.0% (95% CI, 43.3-81.3%), and 78.4% (95% CI, 55.5-90.5%), respectively, in the surgery group and 64.9% (95% CI, 41.7-80.8%), 86.4% (95% CI, 63.3-95.4%), and 62.6% (95% CI, 38.5-79.4%), respectively, in the particle beam group. In chordoma patients, only surgery was significantly correlated with worse LC in the univariate analysis.

CONCLUSIONS

The groups had no significant differences in the OS, LC, and MFS rates. Among the patients with chordomas, the 3-year LC rate in the particle beam group was significantly higher than in the surgery group.

摘要

背景

很少有研究比较骨盆骨肉瘤患者手术治疗和粒子束治疗的临床结果。这是一项多中心回顾性队列研究，比较了日本接受手术治疗和粒子束治疗的骨盆骨肉瘤患者的临床结果。

方法

本研究纳入了日本19个专业肉瘤中心治疗的116例骨盆骨肉瘤患者。57例患者接受了手术（手术组），59例患者接受了粒子束治疗（粒子束组；碳离子放疗：55例患者，质子放疗：4例患者）。

结果

手术组原发肿瘤诊断时的中位年龄为52岁，粒子束组为66岁（P<0.001），手术组肿瘤中位大小为9cm，粒子束组为8cm（P=0.091）。采用Kaplan-Meier法评估116例骨肉瘤患者（手术组57例，粒子束组59例）的总生存率（OS）、局部控制率（LC）和无转移生存率（MFS），并进行比较。倾向评分匹配后，手术组3年OS、LC和MFS率分别为82.9%（95%置信区间[CI]，60.5-93.2%）、66.0%（95%CI，43.3-81.3%）和78.4%（95%CI，55.5-90.5%），粒子束组分别为64.9%（95%CI，41.7-80.8%）、86.4%（95%CI，63.3-95.4%）和62.6%（95%CI，38.5-79.4%）。在脊索瘤患者中，单因素分析显示只有手术与较差的LC显著相关。