Li Ziming, Yu Xiuchun, Xu Ming
Department of Orthopaedics, 960th Hospital of the PLA, Jinan, Shandong, China.
Front Oncol. 2025 Jul 21;15:1490941. doi: 10.3389/fonc.2025.1490941. eCollection 2025.
Refractory leiomyosarcoma (LMS) is characterized by notoriously high recurrence rates and poses significant surgical challenges due to its anatomical complexity and invasive growth patterns. When complete surgical resection proves unattainable, radiotherapy has emerged as a cornerstone therapeutic modality, with emerging evidence suggesting synergistic effects when combined with novel chemotherapeutic agents. This study presents an illustrative case of advanced popliteal fossa LMS managed through precision radiotherapy combined with anlotinib, a multi-target tyrosine kinase inhibitor, which achieved sustained local tumor control and progression-free survival over 18 months of follow-up. Notably, the comprehensive management strategy for treatment-related complications, particularly radiation-induced dermatitis and hematological toxicity, demonstrated clinically validated mitigation approaches through phased dose adjustment and supportive care protocols. The therapeutic paradigm described herein provides valuable insights for optimizing multimodal management of refractory soft tissue sarcomas, highlighting the potential of targeted therapy-radiotherapy combinations while emphasizing the critical importance of proactive complication surveillance in contemporary oncological practice.
难治性平滑肌肉瘤（LMS）的特点是复发率极高，由于其解剖结构复杂和侵袭性生长模式，给手术带来了重大挑战。当完全手术切除无法实现时，放射治疗已成为一种基石性治疗方式，新出现的证据表明，与新型化疗药物联合使用时具有协同效应。本研究展示了一例晚期腘窝LMS病例，通过精准放疗联合多靶点酪氨酸激酶抑制剂安罗替尼进行治疗，在18个月的随访中实现了持续的局部肿瘤控制和无进展生存期。值得注意的是，针对治疗相关并发症，特别是放射性皮炎和血液学毒性的综合管理策略，通过分阶段剂量调整和支持性护理方案，展示了经过临床验证的缓解方法。本文所述的治疗模式为难治性软组织肉瘤的多模式管理优化提供了有价值的见解，突出了靶向治疗与放疗联合的潜力，同时强调了在当代肿瘤学实践中积极监测并发症的至关重要性。
