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在全部实质性肿瘤中,组成恶性间质肿瘤的软组织肉瘤约占1%,其中15%位于腹膜后。手术完全切除率约50%,但术后的复发率超过90%。为了进一步改善病灶的局部控制,作者随机采用术中放疗以观察其疗效。排除病灶已弥散或未完全切除、组织学诊断不明等病例外,对35例符合研究要求者进行分析和随访,计Ⅱ、Ⅲ和Ⅳ期肉瘤分别为6、12和17例。15例接受术中放疗20Gy和术后外照射放疗35～40Gy,作为实验组;另20例仅在术后接受外照射放疗50～55Gy,作为对照组。从两组随机选出13例病人,6例给辅佐化疗,7例不用化疗,化疗方案为阿霉素70mg/m~2、环磷酰胺700mg/m~2和氨甲蝶吟50～250mg/kg。全部随访5年以上,中位值为8年。
In all solid tumors, soft tissue sarcomas that make up a malignant stromal tumor account for about 1%, with 15% behind the retroperitoneum. The total resection rate was about 50%, but the postoperative recurrence rate was over 90%. In order to further improve the local control of the lesion, the authors randomly used intraoperative radiotherapy to observe its efficacy. Excluding cases with diffuse or incomplete resection of lesions and unknown histological diagnosis, 35 patients who met the study requirements were analyzed and followed up. The number of stage II, III, and IV sarcomas was 6, 12, and 17, respectively. Fifteen patients received 20Gy intraoperative radiotherapy and 35～40Gy external radiotherapy after surgery as an experimental group; the other 20 patients only received 50-55Gy external radiotherapy as a control group. Thirteen patients were randomly selected from the two groups. Six patients received adjuvant chemotherapy and seven patients did not receive chemotherapy. The chemotherapy regimens were adriamycin 70 mg/m 2 , cyclophosphamide 700 mg/m 2 and methotrexate 50–250 mg/. Kg. All follow-up of more than 5 years, the median value of 8 years.