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Abstract：
These guidelines were drawn up following a consensus meeting of UK sarcoma specialists convened under the auspices of the British Sarcoma Group and are intended to provide a framework for the multidisciplinary care of patients with soft tissue sarcomas. The guidelines published by the European Society of Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN) were used as the basis for discussion and adapted according to UK clinical practice and local requirements. Note was also taken of the National Institute for Health and Clinical Excellence (NICE) improving outcomes guidance (IOG) for people with sarcoma and existing technology appraisals. The guidelines are not intended to challenge NICE guidance but discrepancies may exist where current guidance does not reflect an international standard of care owing to the ever-evolving nature of cancer treatment. It is acknowledged that these guidelines will require updating on a regular basis. An appendix lists the key recommendations which are summarised below. Any patient with a suspected soft tissue sarcoma should be referred to a diagnostic centre and managed by a specialist sarcoma multidisciplinary team. Surgical excision followed by post operative radiotherapy is the standard management of high grade limb sarcomas although occasionally amputation remains the only option. Pre-operative treatment with chemotherapy or radiotherapy should be considered for patients with borderline resectable tumours. Isolated limb perfusion may permit limb salvage in some cases where amputation is the only other option. Adjuvant chemotherapy is not routinely recommended but may be considered in certain specific situations. Regular follow up is recommended to assess local control and the development of metastatic disease. Single agent doxorubicin is the standard first line therapy for metastatic disease. Ifosfamide is an alternative if anthracyclines are contraindicated. Combination therapy may be considered in individual patients. Second line agents include ifosfamide, dacarbazine, trabectedin and the combination of gemcitabine + docetaxel. Surgical resection of local recurrence and pulmonary metastases should be considered in individual patients. There is specific guidance on the management of retroperitoneal and uterine sarcomas.
摘要：
这些指南是在英国肉瘤小组主持下召开的英国肉瘤专家共识会议之后制定的，旨在为软组织肉瘤患者的多学科护理提供框架。欧洲医学肿瘤学会（ESMO）和国家综合癌症网络（NCCN）发布的指南被用作讨论的基础，并根据英国临床实践和当地要求进行了调整。还注意到美国国家卫生与临床卓越研究所（NICE）改善了肉瘤患者的结果指导（IOG）和现有技术评估。该指南并非旨在挑战NICE指南，但由于癌症治疗的不断发展，当前指南未反映国际护理标准，可能存在差异。人们承认，这些准则将需要定期更新。附录列出了以下概述的主要建议。任何疑似软组织肉瘤的患者都应转诊至诊断中心，并由专科肉瘤多学科团队管理。手术切除后进行术后放疗是高级肢体肉瘤的标准治疗方法，尽管偶尔截肢仍然是唯一的选择。对于边缘可切除肿瘤的患者，应考虑进行化疗或放疗的术前治疗。在截肢是唯一的其他选择的某些情况下，隔离肢体灌注可以挽救肢体。辅助化疗不是常规推荐的，但在某些特定情况下可以考虑。建议定期随访以评估局部控制和转移性疾病的发展。单药阿霉素是转移性疾病的标准一线疗法。如果蒽环类药物禁忌，异环磷酰胺是一种替代品。在个体患者中可以考虑联合治疗。二线药物包括异环磷酰胺，达卡巴嗪,曲贝替丁和吉西他滨+多西他赛的组合。个别患者应考虑手术切除局部复发和肺转移。对腹膜后和子宫肉瘤的处理有具体指导。
