Mark R J, Bailet J W, Poen J, Tran L M, Calcaterra T C, Abemayor E, Fu Y S, Parker R G
Radiation Medical Group, San Diego, California.
Cancer. 1993 Aug 1;72(3):887-93. doi: 10.1002/1097-0142(19930801)72:3<887::aid-cncr2820720338>3.0.co;2-5.
With improvement in survival after cancer treatment, it is becoming increasingly important to study treatment-related morbidity and mortality. Sarcoma can develop in the irradiated field after radiation therapy. The authors performed a study to estimate the risk, and compared the risk of sarcoma after radiation therapy with that of other treatment modalities used against cancer.
Between 1955 and 1988, 229 patients with sarcoma of the head and neck were seen at the University of California, Los Angeles (UCLA), Medical Center. Of these, 13 (6%) had a previous history of radiation therapy to the head and neck.
Radiation doses were known in 10 of 13 patients and ranged from 30 to 124.4 Gy. The latency time from radiation therapy to the development of postirradiation sarcoma (PIS) ranged from 3 months to 50 years, with a median of 12 years. More than 2000 patients have received radiation therapy to the head and neck for various conditions at the UCLA Medical Center since 1955.
The authors conclude that most head and neck sarcomas are not radiation related and that the risk of PIS after head and neck irradiation for other diseases is low. From a review of the literature comparing mortality risks of chemotherapy, general surgery, and anesthesia, the risk of PIS appears no worse. Given the large number of patients who can be cured or receive palliation with radiation therapy, concern about PIS should not be a major factor influencing treatment decisions in patients with cancer.
随着癌症治疗后生存率的提高，研究治疗相关的发病率和死亡率变得越来越重要。肉瘤可在放射治疗后的照射野内发生。作者进行了一项研究以评估风险，并将放射治疗后肉瘤的风险与用于治疗癌症的其他治疗方式的风险进行比较。
1955年至1988年间，加利福尼亚大学洛杉矶分校（UCLA）医学中心诊治了229例头颈部肉瘤患者。其中，13例（6%）既往有头颈部放射治疗史。
13例患者中有10例已知放射剂量，范围为30至124.4 Gy。从放射治疗到放射后肉瘤（PIS）发生的潜伏期为3个月至50年，中位时间为12年。自1955年以来，UCLA医学中心有超过2000例患者因各种疾病接受过头颈部放射治疗。
作者得出结论，大多数头颈部肉瘤与放射无关，头颈部因其他疾病接受放射治疗后发生PIS的风险较低。通过对比较化疗、普通外科手术和麻醉死亡率风险的文献回顾，PIS的风险似乎并不更高。鉴于大量患者可通过放射治疗治愈或缓解，对PIS的担忧不应成为影响癌症患者治疗决策的主要因素。
