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Neoadjuvant radiation improves margin-negative resection rates in extremity sarcoma but not survival.

新辅助放疗可提高肢体肉瘤的切缘阴性切除率,但不能提高生存率。

  • 影响因子:2.88
  • DOI:10.1002/jso.25905
  • 作者列表:"Shelby RD","Suarez-Kelly LP","Yu PY","Hughes TM","Ethun CG","Tran TB","Poultsides G","King DM","Bedi M","Mogal H","Clarke C","Tseng J","Roggin KK","Chouliaras K","Votanopoulos K","Krasnick BA","Fields RC","Pollock RE","Howard JH","Cardona K","Grignol V
  • 发表时间:2020-06-01
Abstract

BACKGROUND AND OBJECTIVES:Radiation improves limb salvage in extremity sarcomas. Timing of radiation therapy remains under investigation. We sought to evaluate the effects of neoadjuvant radiation (NAR) on surgery and survival of patients with extremity sarcomas. MATERIALS AND METHODS:A multi-institutional database was used to identify patients with extremity sarcomas undergoing surgical resection from 2000-2016. Patients were categorized by treatment strategy: surgery alone, adjuvant radiation (AR), or NAR. Survival, recurrence, limb salvage, and surgical margin status was analyzed. RESULTS:A total of 1483 patients were identified. Most patients receiving radiotherapy had high-grade tumors (82% NAR vs 81% AR vs 60% surgery; P < .001). The radiotherapy groups had more limb-sparing operations (98% AR vs 94% NAR vs 87% surgery; P < .001). NAR resulted in negative margin resections (90% NAR vs 79% surgery vs 75% AR; P < .0001). There were fewer local recurrences in the radiation groups (14% NAR vs 17% AR vs 27% surgery; P = .001). There was no difference in overall or recurrence-free survival between the three groups (OS, P = .132; RFS, P = .227). CONCLUSION:In this large study, radiotherapy improved limb salvage rates and decreased local recurrences. Receipt of NAR achieves more margin-negative resections however this did not improve local recurrence or survival rates over.

摘要

背景和目的: 放射治疗可改善肢体肉瘤的保肢。放射治疗的时机仍在调查中。我们试图评估新辅助放疗 (NAR) 对四肢肉瘤患者手术和生存期的影响。 材料和方法: 使用多机构数据库来识别 2000-2016 例接受手术切除的四肢肉瘤患者。根据治疗策略对患者进行分类: 单独手术、辅助放疗 (AR) 或NAR。分析生存率、复发、保肢和手术切缘状态。 结果: 共确定了 1483 例患者。大多数接受放疗的患者为高级别肿瘤 (82% NAR vs 81% AR vs 60% 手术; P <.001)。放疗组有更多的保肢手术 (98% AR vs 94% NAR vs 87% 手术; P <.001)。NAR导致切缘阴性切除 (90% NAR vs 79% 手术vs 75% AR; P <.0001)。放疗组局部复发较少 (14% NAR vs 17% AR vs 27% 手术; P =.001)。三组间总体或无复发生存率无差异 (OS,p = 132; RFS,p =.227)。 结论: 在这项大型研究中,放疗提高了保肢率,降低了局部复发率。接受NAR可获得更多边缘阴性切除,但这并不能改善局部复发率或生存率。

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发表时间:2020-03-01
DOI:10.1177/1078155219842277
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影响因子:2.83
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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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