Retroperitoneal liposarcoma: the role of adjuvant radiation therapy and the prognostic factors.
Retroperitoneal liposarcoma: the role of adjuvant radiation therapy and the prognostic factors.
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DOI：
10.3857/roj.2016.01858
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发表时间：
2016-09
影响因子：
2.3
通讯作者：
Kim SJ
中科院分区：
文献类型：
--
作者：
Lee HS;Yu JI;Lim DH;Kim SJ
评价腹膜后脂肪肉瘤（RPLS）大体肿瘤切除后辅助放疗（RT）的益处。我们回顾了2000年1月至2013年12月期间手术治疗的77例原发性RPLS患者。有大体残留病变的病例被排除。根据法国癌症中心联合会肉瘤组（FNCLCC）系统评价肿瘤分级。32例患者（42%）单独使用外部射束RT进行辅助RT。中位随访时间为36个月（范围：5 - 169）。77例中高分化型33例（43%），去分化型31例（40%），黏液样/圆形8例（10%），多形性4例（5%）。RT组的分化程度低于手术组（28% vs. 53%）。在随访期间，34例（44%）患者出现局部复发。RT组的局部复发率（38%）低于手术组（49%）。3年局部控制率（LC）为55.6%，3年总生存率（OS）为82.1%。肿瘤组织学和FNCLCC分级与局部复发显著相关。在LC中添加辅助RT没有统计学显著性（p = 0.312）。然而，肿瘤组织学类型不是高分化亚型的患者在辅助RT后局部复发率略有下降（3年LC，RT 43.9% vs.无RT 35.3%; p = 0.087）。接受RT的RPLS患者局部复发较少。我们认为，辅助RT的增加可能与LC的改善有关，特别是在组织学亚型不佳的患者中。
To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169). Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087). RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.