滑膜肉瘤术后放射治疗81例

POSTOPERATIVE RADIOTHERAPY FOR SYNOVIOSARCOMA:NALYSIS OF 81 PATIENTS

我院１９６４一１９８７年收治了８１例滑膜肉瘤患者。本文分析不同治疗方法对预后的影响，术后放疗组和单纯手术组的３、５年生存率分别为５２０％、４２．０％和４１．９％、２５．８％（Ｐ＞０．０５），局部复发率分别为１２．８％和６８．８％（Ｐ＜０．０１）。患者年龄对预后影响较大，３０－６５岁组和１０－２９岁组的３、５年生存率分别为５８．７％，４１．３％和３４．３％，２８．６％（Ｐ＜０．０５）。而病变部位与疗效无关。本组病例治疗失败的一重要原因是血行转移（４５．８％）。我们认为发病无明显症状而延搁诊治、不恰当穿刺或活检，局部复发而多次手术可能是增加血行转移的原因。本组肺转移３１例，其中９例曾用各种不同化疗方案治疗，但均于１年内死亡。

AbstractThe influence factors of prognosis on synoviosarcoma treated by various me-thods was analyzed.The 3-and 5-year survival rates were 52%and 42%in post-operative radiotherapy plus surgery group, and 42%and 25.8%in surgery alonegroup(p>0.05). Local recurrence rates were 12.8%and 68.8%in the above twogroups(p<0.01). The patient' s age vias closely related to prognosis with the 3-and 5-year suvival rates of 58.7%and 41.3%in the group of aged 30-65, and 34.4%and 28.6%in aged 10-29 group.45.8%patients died of distant metastasis. Delayof treatment, improper aspiration or excision biopsy and repeated surgery for recu-rrence are prone to distant metastasis. 9 of 3 1 patients with lung metastasis diedwithin one year despite different chemotherapy regiments.