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[成人软组织肉瘤的治疗结果]

[Treatment results of soft tissue sarcomas in adults].

作者信息

Wagner W, Willich N, Rübe C, Prott F J, Micke O

机构信息

Klinik und Poliklinik für Strahlentherapie-Radioonkologie-der Westfälischen Wilhelms-Universität Münster.

出版信息

Strahlenther Onkol. 1994 Feb;170(2):91-9.

PMID:8108787
Abstract

PURPOSE

An appropriate therapeutical concept for soft tissue sarcomas is unknown particularly since that our knowledge about these neoplasms is considerably incomplete partly resulting from a low incidental rate distributed to many subentities. Children and adolescents were aggressively and multimodally treated. The standard therapy of the adults is an resection as radical as possible followed by adjuvant radiotherapy. The aim of our study was to show the treatment results of our clinic and to investigate survival rates, local tumor control and prognostic factors.

PATIENTS AND METHODS

Between 1965 and 1989, a total of 51 male and 49 female were treated for soft tissue sarcoma at the University Hospital of Münster.

RESULTS

The overall five-year survival rate (actuarial survival) was 43.1%. 27% of the patients developed a local recurrence, 45% distant metastases. Lymph node metastases occurred in 4% of the patients. Tumor size was a prognostic factor for the five-year survival rates (T1 = 59.8%, T2 = 44.0%, T3 = 26.0%). The best results were achieved after combined treatment using surgery (wide resection) and postoperative high dose radiotherapy. Compared to wide resection alone, the combined treatment had a significantly higher five-year survival rate (59.7% vs. 26%). There was no significant improvement using adjuvant postoperative chemotherapy.

CONCLUSION

In our study we could show a remarkable improvement of the five-year survival rate by adjuvant radiotherapy after surgical resection versus surgery alone and demonstrate the importance of radiotherapy in the treatment of soft tissue sarcoma.

摘要

目的

软组织肉瘤的合适治疗理念尚不清楚,尤其是因为我们对这些肿瘤的了解相当不完整,部分原因是其发病率低且涵盖许多亚型。儿童和青少年接受了积极的多模式治疗。成人的标准治疗是尽可能进行根治性切除,然后进行辅助放疗。我们研究的目的是展示我们诊所的治疗结果,并调查生存率、局部肿瘤控制情况和预后因素。

患者与方法

1965年至1989年间,明斯特大学医院共治疗了51例男性和49例女性软组织肉瘤患者。

结果

总体五年生存率(精算生存率)为43.1%。27%的患者出现局部复发,45%出现远处转移。4%的患者发生淋巴结转移。肿瘤大小是五年生存率的一个预后因素(T1 = 59.8%,T2 = 44.0%,T3 = 26.0%)。采用手术(广泛切除)和术后高剂量放疗的联合治疗取得了最佳效果。与单纯广泛切除相比,联合治疗的五年生存率显著更高(59.7%对26%)。辅助性术后化疗没有显著改善。

结论

在我们的研究中,我们可以证明手术切除后辅助放疗与单纯手术相比,五年生存率有显著提高,并证明了放疗在软组织肉瘤治疗中的重要性。

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