Dunst J, Jabar S, Paulussen M, Jürgens H
Strahlentherapeutische Klinik und Poliklinik, Universität Erlangen-Nürnberg.
Klin Padiatr. 1994 Jul-Aug;206(4):277-81. doi: 10.1055/s-2008-1046614.
In CESS 86, radiotherapy and surgery as local treatment modalities yielded the same survival rates. Irradiated patients developed more local recurrences as compared to surgically treated patients (14% versus 4%), but less systemic metastases (16% versus 28%). The local recurrence rate after definitive radiotherapy dropped from 50% in CESS 81 to 14% in CESS 86. This was probably caused by an earlier start of radiotherapy (in week 10 in CESS 86 as compared to week 19 in CESS 81) and the high quality of radiation therapy in CESS 86 due to central treatment planning (only 2% protocol violations). Patients with local recurrences showed no differences in the distribution of major prognostic parameters (tumor volume, response to chemotherapy) as compared to patients with local control of disease. As a consequence of these results the concept of early irradiation with subsequent "consolidant" surgery for high-risk patients has been established.
在儿童横纹肌肉瘤研究组86（CESS 86）中，作为局部治疗方式的放疗和手术产生了相同的生存率。与接受手术治疗的患者相比，接受放疗的患者出现更多局部复发（14% 对4%），但出现的全身转移较少（16% 对28%）。根治性放疗后的局部复发率从儿童横纹肌肉瘤研究组81（CESS 81）中的50%降至儿童横纹肌肉瘤研究组86（CESS 86）中的14%。这可能是由于放疗开始时间提前（儿童横纹肌肉瘤研究组86中为第10周，而儿童横纹肌肉瘤研究组81中为第19周）以及儿童横纹肌肉瘤研究组86中由于中央治疗计划而具有高质量的放射治疗（仅2%违反方案）。与疾病局部得到控制的患者相比，局部复发的患者在主要预后参数（肿瘤体积、对化疗的反应）分布上没有差异。基于这些结果，已确立了对高危患者进行早期放疗随后进行“巩固性”手术的概念。
