躯干四肢软组织肉瘤的放疗

摘要

Limited surgery combined with radiation therapy is the standard treatment modality of soft tis-sue sarcoma of the extremities and trunk.Postoperative radiation therapy can effectively prevent local recur-rence and improve survival in patients with high-risk,and has become increasingly used in the treatment of localized soft tissue sarcoma,though it is associated with a higher rate of long-term fibrosis,edema,and joint stiffness.Preoperative radiation therapy has similar local control and overall survival rates compared with post-operative radiation therapy,but preoperative radiotherapy is associated with a greater risk of wound complica-tions.Using of intensity-modulated radiation technology in the preoperative or postoperative radiotherapy,can minimize dose to uninvolved tissues,reduce complications after therapy,and maintain good limb function.%保留功能的手术结合放疗是躯干四肢软组织肉瘤标准的综合治疗模式。术后放疗能够防止局部复发，对于高危患者还能延长生存期，是目前应用最广泛的辅助治疗方法，但长期纤维化、水肿、关节僵硬的发生率较高。术前放疗的局部控制率和总生存率与术后放疗相似，但手术后切口并发症发生率较高。在术前和术后放疗中采用调强放疗技术，能最大限度地保护正常组织，减少治疗后的并发症，维持良好的肢体功能。