Calais G
Clinique d'oncologie et radiothérapie, centre hospitalier universitaire, Tours, France.
Cancer Radiother. 1997;1(5):457-61. doi: 10.1016/s1278-3218(97)89577-7.
Radiation therapy is generally used as a surgical adjuvant in the treatment of soft tissue sarcomas. Postoperative external beam irradiation is the most commonly applied treatment. The majority of retrospective studies have suggested that radiation therapy could reduce the incidence of local recurrence. Radiation is recommended in case of deep tumor location, inadequate surgical margins and grade 3 tumor. A total dose of 55 to 65 Gy using large volume with initial field margin of 5 cm are recommended. Radiation therapy can also be delivered in preoperative fashion, but the majority of the studies have reported a higher wound complication rate. The value of brachytherapy for reducing the risk of local recurrence has been demonstrated in a randomized trial, especially for patients with high grade tumors. The combination of external radiation (40 to 45 Gy) and brachytherapy (15 to 20 Gy) seems to be the optimal adjuvant local strategy.
放射治疗通常用作软组织肉瘤治疗的手术辅助手段。术后外照射是最常用的治疗方法。大多数回顾性研究表明,放射治疗可降低局部复发的发生率。对于深部肿瘤位置、手术切缘不足和3级肿瘤的情况,建议进行放射治疗。推荐使用初始野边缘为5厘米的大体积照射,总剂量为55至65 Gy。放射治疗也可以在术前进行,但大多数研究报告伤口并发症发生率较高。一项随机试验证明了近距离放射治疗在降低局部复发风险方面的价值,特别是对于高级别肿瘤患者。外照射(40至45 Gy)和近距离放射治疗(15至20 Gy)的联合似乎是最佳的辅助局部治疗策略。