骨盆区放射诱导肉瘤五例分析

The analysis of five patients for pelvic radiation-induced sarcoma

目的探讨骨盆放疗诱导肉瘤发病特点、治疗方案及预后。方法 2014~2017年收治5例骨盆区放疗后诱导肉瘤患者的临床资料及随访。结果 5例骨盆放疗诱导后肉瘤,均为女性,原发肿瘤为子宫内膜癌2例、宫颈癌2例、恶性畸胎瘤1例,放疗后至发病时间间隔为(13.6±4.7)年。4例出现肺转移。3例手术及化疗,1例单纯手术治疗,1例化疗。病理结果 4例为骨肉瘤,1例为平滑肌肉瘤。5例随访3~11个月死亡。结论骨盆放疗后肉瘤恶性程度高,血供丰富,常伴远处转移,预后极差,预期发病率上升,建议姑息性手术及化疗。

Objective To explore clinical features, treatment and prognosis of pelvic radiation-induced sarcoma. Methods Five cases of pelvic radiation-induced sarcoma（ RIS） underwent tumor excision, internal fixation and chemotherapy from 2014 to 2017. Results All patients were female. Primary tumors included 2 endometrial carcinomas, 2 cervical carcinomas and 1 malignant teratoma. The period from radiotherapy to RIS was（ 13.6 ± 4.7） years. Lung metastases occurred in 4 cases. Three cases received surgery and postoperative chemotherapy, one case received surgery alone and one case received chemotherapy. Histological classification： 4 cases were of osteosarcoma and 1 was of leiomyosarcoma. After the follow-up for 3 to 11 months, all 5 cases died. ConclusionsPelvic radiation-induced sarcoma is highly malignant with rich blood supply. It has dismal prognosis, and high rate to metastasize. Anticipated morbidity of RIS is increasing. Palliative surgery and chemotherapy are suggested.