软组织肉瘤的放射治疗

摘要

软组织肉瘤（soft tissue sarcomas，STS）是起源于结缔组织的软组织恶性肿瘤，具有多种不同类型。手术是STS主要治疗方法，放疗也是其重要的治疗方式并且是综合治疗早期选择之一。对STS进行放疗已经超过50年历史，术前和术后放疗对于局部控制都有疗效，只是不良反应不同。软组织肉瘤放疗技术包括远距离放疗（适形放疗、调强放疗、立体定向放疗等）、近距离放疗（组织间插植放疗、腔内后装放疗、术中放疗等）等。放疗技术的进步，提高了放疗的精准性和确定性，降低了对病灶周围正常组织的损伤。本文主要针对STS放疗技术以及适用原则进行综述。%Soft tissue sarcomas (STS) consist of a heterogeneous group of rare malignancies with mesenchymal origin. Surgical resec-tion is the primary treatment for STS, but radiation therapy (RT) also plays an important role in the treatment. Radiotherapy for STS has advanced significantly over the past 50 years. Both preoperative and postoperative radiotherapies are equivalent in local control but are associated with different toxicity profiles. Boost techniques for STS include brachytherapy, intraoperative radiation therapy (IORT), and external beam. Long-term toxicities of RT to normal tissues have been reduced because of improvements in image guid-ance and intensity-modulated radiotherapy, which significantly increase the precision and delivery of RT. This review discusses RT tech-nologies and their acceptable treatment principles.