Hew L, Kandel R, Davis A, O'Sullivan B, Catton C, Bell R
University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Surg Oncol. 1994 Oct;57(2):111-4. doi: 10.1002/jso.2930570208.
Forty-eight patients with soft tissue sarcomas that presented adverse features for treatment by limb salvage surgery and postoperative irradiation were treated by preoperative irradiation and surgery using a consistent protocol. Following resection, the extent of histological necrosis in the specimen was scored according to the criteria of Willet et al. Of the 48 cases, 16 (34%) demonstrated Grade 1 response (< 50% necrosis), 15 (31%) Grade 2 (50-80% necrosis), and 17 (35%) Grade 3 (> 80% necrosis). There was a trend toward more extensive necrosis in liposarcoma tumors (53% showing Grade 3 response compared to 26% of other sarcomas). Logistic regression analysis demonstrated a significant relationship between necrosis and tumor size (P < 0.001) with larger tumors having higher grades of necrosis. Tumor grade did not seem to affect the extent of necrosis. In comparison to the previous report of necrosis in soft tissue sarcoma following irradiation, the current analysis revealed a smaller proportion of tumors with Grade 3 necrosis.
48例软组织肉瘤患者因具有不利于保肢手术及术后放疗的特征，采用一致方案进行术前放疗及手术治疗。切除术后，根据Willet等人的标准对标本中的组织学坏死程度进行评分。48例患者中，16例（34%）显示1级反应（坏死<50%），15例（31%）为2级（坏死50-80%），17例（35%）为3级（坏死>80%）。脂肪肉瘤肿瘤有更广泛坏死的趋势（53%显示3级反应，而其他肉瘤为26%）。逻辑回归分析显示坏死与肿瘤大小之间存在显著关系（P<0.001），肿瘤越大坏死程度越高。肿瘤分级似乎不影响坏死程度。与先前关于软组织肉瘤放疗后坏死的报告相比，当前分析显示3级坏死的肿瘤比例较小。
