Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity: 20-year follow-up of a randomized prospective trial.
Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity: 20-year follow-up of a randomized prospective trial.
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DOI：
10.1245/s10434-014-3732-4
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发表时间：
2014-08
影响因子：
3.7
通讯作者：
Rudloff U
中科院分区：
文献类型：
--
作者：
Beane JD;Yang JC;White D;Steinberg SM;Rosenberg SA;Rudloff U
本随机前瞻性研究的更新介绍了外照射放射治疗（EBRT）对肢体软组织肉瘤（STS）保肢手术（LSS）后长期总生存率、局部控制和肢体功能的影响。LSS后，肢体STS患者随机接受EBRT或单纯手术。所有高级别STS患者均接受辅助化疗。长期随访是通过电话访谈，使用问卷调查的基础上验证的方法。采用Kaplan-Meier法计算总生存期（OS）。共有141例四肢STS患者随机接受辅助EBRT（n = 70）或LSS单独治疗（n = 71）。中位随访时间为17.9年。单独接受LSS治疗的患者的10年和20年生存率分别为77%（95%CI 66- 85%）和64%（95%CI 52- 75%），接受EBRT治疗的患者分别为82%（95%CI 72- 90%）和71%（95%CI 59- 81%）（p = 0.22）。在完成电话访谈的54例患者中，随访期间局部复发的发生率在单独LSS队列中为4%（1/24），而接受EBRT的患者为0%（0/30）（p = 0.44）。接受EBRT治疗的患者往往有更多的伤口并发症（17 vs. 12.5%，p = 0.72）、临床显著水肿（25 vs. 12%，p = 0.31）和肢体功能缺陷（15 vs. 12%，p = 0.84）。肢体STS术后辅助EBRT提供了极好的局部控制，治疗相关的发病率可接受，总生存率无统计学显著改善。
This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS). Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemo-therapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan–Meier method. A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10-and 20-year survival was 77 % (95 % CI 66–85 %) and 64 % (95 % CI 52–75 %) for patients receiving LSS alone and 82 % (95 % CI 72–90 %) and 71 % (95 % CI 59–81 %) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 % (1 of 24) in the LSS alone cohort compared with 0 % (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 %, p = 0.72), clinically significant edema (25 vs. 12 %, p = 0.31), and functional limb deficits (15 vs. 12 %, p = 0.84). Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.
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影响因子：
45.3
作者：
CHANG, AE;STEINBERG, SM;ROSENBERG, SA
通讯作者：
ROSENBERG, SA
影响因子：
3
作者：
Livi, L;Santoni, R;Biti, G
通讯作者：
Biti, G
影响因子：
45.3
作者：
Pisters, PWT;Harrison, LB;Brennan, MF
通讯作者：
Brennan, MF
影响因子：
9
作者：
Cahlon, Oren;Brennan, Murray F.;Alektiar, Kaled M.
通讯作者：
Alektiar, Kaled M.
影响因子：
10.3
作者：
FISHER, B;WOLMARK, N;ROBIDOUX, A
通讯作者：
ROBIDOUX, A