Cakir S, Dincbas F O, Uzel O, Koca S S, Okkan S
Department of Radiation Oncology, Ondokuz Mayis University, Medical School, Kurupelit, Samsun, Turkey.
Radiother Oncol. 1995 Oct;37(1):10-6. doi: 10.1016/0167-8140(95)01614-m.
The results of 75 patients with soft-tissue sarcomas treated by the combination of local surgical excision plus postoperative radiotherapy are reported. Thirty-five tumors were situated in the extremities, 32 in the trunk, and eight in the head and neck. Twenty-eight tumors were high grade, 33 intermediate and 14 low grade. Sixty-two patients had complete resections (wide or marginal) and 13 incomplete resections (intralesional). Radiation was administered with a shrinking-field technique (median total dose, 64 Gy; range, 50-78). Twenty-five patients developed local recurrence (33%). The 5-year local control rate was 67%. On univariate analysis, a tumor site other than extremity (p < 0.05), unfavorable histology (p < 0.01), and incomplete resection (p < 0.01) were poor risk factors for local recurrence. When multivariate analysis were performed, only incomplete resection (relative risk (RR) 7.2) remained a poor risk factor. The 5-year overall survival rate was 50.5% for the entire group. Following a univariate analysis of host tumor and treatment-related factors, a tumor site other than extremity (p < 0.05), high tumor grade (p < 0.01) unfavorable histology (p < 0.05), and incomplete tumor resection (p < 0.01) were found to significantly increase the risk of further tumor death. Multivariate analysis found high tumor grade (RR 5.6), and incomplete resection (RR 7) to be independent poor risk factors for survival.
报告了75例软组织肉瘤患者采用局部手术切除加术后放疗联合治疗的结果。35个肿瘤位于四肢，32个位于躯干，8个位于头颈部。28个肿瘤为高级别，33个为中级别，14个为低级别。62例患者进行了完整切除（广泛或边缘性），13例为不完整切除（病灶内）。采用缩野技术进行放疗（中位总剂量64 Gy；范围50 - 78）。25例患者出现局部复发（33%）。5年局部控制率为67%。单因素分析显示，非四肢肿瘤部位（p < 0.05）、不良组织学（p < 0.01）和不完整切除（p < 0.01）是局部复发的不良风险因素。进行多因素分析时，只有不完整切除（相对风险（RR）7.2）仍然是不良风险因素。整个组的5年总生存率为50.5%。对宿主肿瘤和治疗相关因素进行单因素分析后发现，非四肢肿瘤部位（p < 0.05）、高肿瘤级别（p < 0.01）、不良组织学（p < 0.05）和不完整肿瘤切除（p < 0.01）显著增加了进一步肿瘤死亡的风险。多因素分析发现高肿瘤级别（RR 5.6）和不完整切除（RR 7）是生存的独立不良风险因素。
