90例软组织肉瘤术后放疗临床分析

目的回顾分析软组织肉瘤术后放射治疗的疗效。方法１９８８年５月～１９９５年５月间收治９０例软组织肉瘤（多次术后复发４０例，首次术后复发５０例），全部用６０Ｃｏ或加深层Ｘ线外照射，常规照射４５～５０Ｇｙ／５ｗ，然后缩野再用６０Ｃｏ或改用深层Ｘ线照射，总剂量低度恶性肉瘤６０Ｇｙ／６ｗ，中度恶性６５Ｇｙ／６．５ｗ，高度恶性７０Ｇｙ／７ｗ。结果３、５年生存率分别为８３．３％（７０／９０）和６１．３％（３８／６２）。局部复发率为５．６％（５／９０），远处转移率为１１．１％（１０／９０）。影响软组织肉瘤的预后因素包括肿瘤大小、恶性程度、临床分期、术后放疗间隔时间。结论放射治疗能大幅度降低软组织肉瘤术后局部复发率。

Postoperative radiotheapy for soft tissue sarcoma:The clinical analysis of 90 cases

Objective To retrospect and analyze the effect of postoperative radiotherapy for soft tissue sarcoma.Methods From May 1988 to May 1995,90 cases (40 cases had been repeatedly resected and 50 cases first resected) with soft tissue sarcoma were all treated by radiotherapy of 60 Co or/and deep x ray after resection.The first was routine irradiation of 45-50 Gy for 5 weeks,and then continuously treated by 60 Co or deep X-ray on reduced field.The dose was 60Gy for 6 weeks on low degree malignant sarcoma,65 Gy for 6.5 weeks on middle degree sarcome and 70Gy for 7 weeks on high degree sarcoma.Results 3-year-survival rate was 83.3%(75/90).5-year-survival rate was 61.3%(38/62),local relapse rate was 5.6%(5/90),distant metastatic rate was 11.1%(10/90).Prognostic factors were the size of tumour,degree of maligniancy,clinical stages and the period between operation and radiotherapy.Conclusion Radiotherapy can greatly decrease the local relapsed rate after operation for soft tissue sarcoma.