术前同步推量调强放疗提高肢体软组织肉瘤RO切除率的研究

Effect of preoperative intensity modulated radiation therapy on RO resection rate of limb soft tissue sarcoma

目的探讨术前同步推量调强放射治疗（SIB—IMRT）提高肢体软组织肉瘤（STS）R0切除率的可能性。方法应用SIB—IMRT技术对32例局部晚期肢体STS患者进行术前放疗，放疗后予以手术治疗。结果术前S1B—IMRT有效率为81．3％（26／32），R0切除率为100．0％，术后伤口一期愈合率为100．0％，急性放射性皮肤损伤4级和5级0例。随访12～36个月，4例肺转移，5例死亡，4例复发，无复发中位生存时间15个月。结论术前SIB—IMRT对提高肢体软组织肉瘤R0切除率具有重要意义，近期疗效确切，患者耐受性较好。

Objective To investigate the possibility of increasing R0 resection rate in limb soft tis- sue sarcoma after simultaneous integrated boost intensity modulated radiation therapy （SIB - IMRT）. Methods 32 patients with locally advanced limb soft tissue sarcoma underwent operation after SIB - IMRT. Results In these 32 patients, the overall effective rate of SIB - IMRT is 81.3% （26/32）, and R0 resection rate is 100. 0%, and primary wound healing rate is 100%, without grade 4 and 5 acute radioactive skin damage. 12 to 36 months follow - up, pulmonary metastasis in 4 cases, died in 5 cases, recurrence in 4 cases, and relapse - free survival is 15 months. Conclusion The preoperative SIB - IMRT is significant in improving the R0 resection rate in limb soft tissue sarcoma, and short - term curative effect is definite, patients with good tolerance.