Carabell S C, Goodman R L
Semin Oncol. 1981 Jun;8(2):201-6.
Soft tissue sarcomas can be adequately treated with wide local excision and postoperative irradiation, rather than the amputation of the affected extremity. Local control and good function can be achieved in the great majority of patients treated with radiation therapy, with particularly good results (95% local control) obtained for lesions of the distal extremity i.e., below the elbow or knee. The most common site of failure is distant metastasis, and the outstanding prognostic indicator is histologic grade. Disease-free survival correlates strongly with grade, with 85%, 51%, and 17% 2-yr disease-free survival for grades 1, 2, and 3, respectively. Lymph node metastasis is an uncommon first site of failure, and prophylactic nodal irradiation or lymphadenectomy is not recommended. The value of chemotherapy or immunotherapy is not firmly established as far as enhancing local control. It is hoped that distant metastasis can be prevented by the use of such adjuvant therapy. Locally advanced, nonresectable sarcoma may be better treated with high linear energy transfer (LET) radiation, and promising results have been reported with fast neutron treatment.
软组织肉瘤可通过广泛局部切除和术后放疗得到充分治疗，而无需对患肢进行截肢。大多数接受放射治疗的患者能够实现局部控制并保留良好功能，对于远端肢体（即肘部或膝部以下）的病变，效果尤为显著（局部控制率达95%）。最常见的失败部位是远处转移，最重要的预后指标是组织学分级。无病生存率与分级密切相关，1级、2级和3级的2年无病生存率分别为85%、51%和17%。淋巴结转移是罕见的首发失败部位，不建议进行预防性淋巴结照射或淋巴结切除术。就增强局部控制而言，化疗或免疫疗法的价值尚未得到确证。希望通过使用此类辅助疗法能够预防远处转移。局部进展、无法切除的肉瘤采用高线性能量传递（LET）放疗可能效果更好，快中子治疗已报告有前景良好的结果。
