软组织肉瘤术后放疗的近期疗效观察

摘要

目的 观察软组织肉瘤术后放疗的近期疗效.方法 176例软组织肉瘤患者,均于局部扩大切除手术后行术后放疗.放疗开始时间为术后17～81 d,平均39 d;采用三维适形或调强放疗33例,常规放疗143例;大部分患者应用高能X射线,其中74例采用电子线照射或电子线与X射线混合照射;放疗剂量平均57.6 GY,常规分割.结果 本组13例未完成放疗,中断原因为放疗皮肤反应7例、非身体原因4例、放疗中放射野内复发1例、肺部感染1例;6例出现局部复发,复发率3.4％.急性反应包括皮肤黏膜急性损伤166例,白细胞减少37例,中性粒细胞减少15例;晚期反应包括皮肤黏膜慢性损伤139例,皮下组织纤维化107例,股骨颈骨折2例.结论 软组织肉瘤术后放疗的近期疗效较好.%Objective To observe the recent curative effect of postoperative radiotherapy in soft tissue sarcoma. Methods 176 cases of soft tissue sarcoma patients were partially extended resection surgery and postoperative radiotherapy. The radiotherapy start time after surgery 17-81 d, average 39 d; 33 cases three-dimensional conformal or intensity modulated radiotherapy, 143 cases conventional radiotherapy. Most of the patients with high-energy X-ray, 74 cases with electron irradiation or electronic line X-ray mixed irradiation. The average radiation dose was 57.6 GY, conventional fractiona-tion. Results This group of patients, 13 patients did not complete the radiotherapy, 7 cases of interruption due to radio- -therapy skin reactions, 4 cases of non-health reasons, 1 case recurrence within the radiation field in the radiotherapy, 1 case of lung infection. 6 cases of local recurrence, the recurrence rate of 3.4%. Acute reactions, including 166 cases of a-cute injury of skin and mucous membrane, 37 cases of leucopenia, IS cases of neutropenia. Late reaction, including 139 cases of the skin and mucosa of chronic injury, 107 cases of subcutaneous tissue fibrosis, 2 cases of femoral neck fracture. Conclusion Soft tissue sarcoma curative effect of postoperative radiotherapy is better.