软组织肉瘤保存肢体的新技术应用

Limb-preserving Treatment Soft Tissue Sarcomas

应用广泛切除术及高剂量率后装内照射新技术（Ｂｒａｃｈｙｔｈｅｒａｐｙ），治疗累及重要血管及神经的软组织肉瘤，达到控制预防局部复发，保存肢体功能的目的。５例肢体软组织肉瘤经治疗后均生存，随访未见局部复发及远处转移。作者介绍了保存肢体手术及肿瘤床１９２铱置管内照射的技术，同时建议对以往截肢指征应慎重考虑，只有在各种综合治疗失败情况下才考虑截肢。

At Shanghai Cancer Hospital,interstitial radiation (Brachytherapy)of the tumor bed after resection of soft tissue sarcomas with involvement of adjacent neurovascular bundle was used to improve local tumor control on the one hand and to maximize preservation of function of the limb on the other hand.The results of treatment in a series of 5 patients were gratifying,and none of 5cases developed local tumor recurrence nor distant metastasis after combined surgical excision and brachytherapy.The authors provided their experience of the treatment with soft tissue sarcomas of the limb using function-saving excision and temporary implants of irridium192 sources in the tumor bed.It is proposed that the indication for amputation in the past should be strictly scrutinized to those instances when effective multimodality therapy would fail.