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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma.
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Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma.

机译：肢体软组织肉瘤术前与术后放疗随机分配后的晚期放射病发病率。

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BACKGROUND AND PURPOSE: This study compared late radiation morbidity in patients with extremity soft tissue sarcoma randomized to treatment by pre- (50 Gy) or postoperative (66 Gy) radiotherapy in combination with surgery. The morbidities evaluated included fibrosis, joint stiffness and edema at 2 years following treatment. The impact of morbidity on patient function as measured by the Musculoskeletal Tumor Rating Scale (MSTS) and the Toronto Extremity Salvage Score (TESS) was also evaluated. PATIENTS AND METHODS: 129 patients were evaluated. Toxicity rates were compared by treatment arm using the Fisher's exact test. Function scores by toxicity were analyzed using the Wilcoxon rank sum test. Multivariate logistic regression was used to evaluate the joint effect of treatment arm, field size, and dose on subcutaneous tissue fibrosis, joint stiffness and edema. RESULTS: 27 of 56 patients (48.2%) in the postoperative arm compared to 23 of 73 (31.5%) in the preoperative arm had grade 2 or greater fibrosis (P = 0.07). Although not statistically significant, edema was more frequent in the postoperative arm, 13 of 56 (23.2%) versus 11 of 73 (15.5%) in the preoperative arm, as was joint stiffness, 13 of 56 (23.2%) versus 13 of 73 (17.8%). Patients with significant fibrosis, joint stiffness or edema had significantly lower function scores on both measures (all P-values < 0.01). Field size was predictive of greater rates of fibrosis (P = 0.002) and joint stiffness (P = 0.006) and marginally predictive of edema (P = 0.06). CONCLUSIONS: Patients treated with postoperative radiotherapy tended to have greater fibrosis. Fibrosis, joint stiffness and edema adversely affect patient function.
机译：背景与目的：本研究比较了随机接受肢体软组织肉瘤患者的晚期放射线发病率，这些患者随机接受术前（50 Gy）或术后（66 Gy）放疗联合手术治疗。治疗后2年评估的发病率包括纤维化，关节僵硬和水肿。还评估了发病率对肌肉骨骼肿瘤分级量表（MSTS）和多伦多肢体救助评分（TESS）所衡量的患者功能的影响。患者与方法：对129例患者进行了评估。治疗组使用Fisher精确检验比较毒性率。使用Wilcoxon秩和检验分析了通过毒性进行的功能评分。多因素logistic回归用于评估治疗臂，视野大小和剂量对皮下组织纤维化，关节僵硬和浮肿的关节作用。结果：术后组中56例患者中有27例（48.2％），而术前组中73例中有23例（31.5％）有2级或更高的纤维化（P = 0.07）。尽管无统计学意义，但术后臂水肿的发生率更高，术前臂中的13例为56（23.2％），而术前臂中的11例为73（15.5％），关节僵硬为56例中的13例（23.2％）对73例为13 （17.8％）。纤维化，关节僵硬或水肿严重的患者，两种方法的功能评分均显着降低（所有P值<0.01）。视野大小可预示纤维化发生率更高（P = 0.002）和关节僵硬（P = 0.006），而对水肿的预测则很小（P = 0.06）。结论：术后放射治疗的患者倾向于发生更大的纤维化。纤维化，关节僵硬和水肿会对患者的功能产生不利影响。

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