Abstract：
To assess oncological outcomes of patients receiving neoadjuvant radiochemotherapy (RCT) for soft tissue sarcoma (STS) of the extremities.
Patients who were treated with preoperative radiotherapy and concomitant chemotherapy-3 cycles of mitomycin/doxorubicin/cisplatin (MAP) or 2-4 cycles of doxorubicin/cisplatin (AP)-followed by surgery were analyzed retrospectively. Survival rates were estimated, and prognostic factors were identified.
Between 1994 and 2017, a total of 108 patients were included. Median ages were 43 years and 51 years for patients receiving MAP and AP, respectively. The 5‑year local relapse-free survival (LRFS), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) were 94.1, 63.6, 75.3, and 71.9%, respectively. In the multivariate analysis, significant predictors were identified as follows: de novo or R1/R2 resected tumor on admission before RCT (p = 0.017; hazard ratio [HR] 0.112, 95% confidence interval [CI] 0.019-0.675) and R0 resection after RCT (p = 0.010; HR 0.121, 95% CI 0.024-0.598) for LRFS; female gender (p = 0.042; HR 0.569, 95% CI 0.330-0.979) and liposarcoma histology (p = 0.014; HR 0.436, 95% CI 0.224-0.845) for DFS; liposarcoma histology (p = 0.003; HR 0.114, 95% CI 0.027-0.478) and AP regimen (p = 0.017; HR 0.371, 95% CI 0.165-0.836) for DSS; age ≤ 45 years (p = 0.043; HR 0.537, 95% CI 0.294-0.980) and liposarcoma histology (p = 0.006; HR 0.318, 95% CI 0.141-0.716) for OS, respectively.
An increased risk for local failure seems to exist for patients with relapsed tumor on admission and having positive surgical margins after neoadjuvant RCT. Intensity of chemotherapy influenced DSS but not OS, which could be due to younger patients receiving MAP.
Patients who were treated with preoperative radiotherapy and concomitant chemotherapy-3 cycles of mitomycin/doxorubicin/cisplatin (MAP) or 2-4 cycles of doxorubicin/cisplatin (AP)-followed by surgery were analyzed retrospectively. Survival rates were estimated, and prognostic factors were identified.
Between 1994 and 2017, a total of 108 patients were included. Median ages were 43 years and 51 years for patients receiving MAP and AP, respectively. The 5‑year local relapse-free survival (LRFS), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) were 94.1, 63.6, 75.3, and 71.9%, respectively. In the multivariate analysis, significant predictors were identified as follows: de novo or R1/R2 resected tumor on admission before RCT (p = 0.017; hazard ratio [HR] 0.112, 95% confidence interval [CI] 0.019-0.675) and R0 resection after RCT (p = 0.010; HR 0.121, 95% CI 0.024-0.598) for LRFS; female gender (p = 0.042; HR 0.569, 95% CI 0.330-0.979) and liposarcoma histology (p = 0.014; HR 0.436, 95% CI 0.224-0.845) for DFS; liposarcoma histology (p = 0.003; HR 0.114, 95% CI 0.027-0.478) and AP regimen (p = 0.017; HR 0.371, 95% CI 0.165-0.836) for DSS; age ≤ 45 years (p = 0.043; HR 0.537, 95% CI 0.294-0.980) and liposarcoma histology (p = 0.006; HR 0.318, 95% CI 0.141-0.716) for OS, respectively.
An increased risk for local failure seems to exist for patients with relapsed tumor on admission and having positive surgical margins after neoadjuvant RCT. Intensity of chemotherapy influenced DSS but not OS, which could be due to younger patients receiving MAP.
摘要：
目的：评估四肢软组织肉瘤（STS）接受新辅助放化疗（RCT）患者的肿瘤预后。
方法：对术前放疗联合3个周期的丝裂霉素/多柔比星/顺铂（MAP）或2-4个周期的多柔比星/顺铂（AP）进行手术治疗的患者进行回顾性分析。估计生存率，并确定了预后因素。
结果：在1994年至2017年之间，共纳入108例患者。接受MAP和AP的患者的中位年龄分别为43岁和51岁，分别。5年局部无复发生存率（LRFS），无病生存率（DFS），疾病特异性生存率（DSS），总生存率（OS）分别为94.1、63.6、75.3和71.9％，分别。在多变量分析中，确定了重要的预测因素如下：RCT前入院时从头或R1/R2切除的肿瘤（p=0.017；风险比[HR]0.112，95％置信区间[CI]0.019-0.675）和R0切除后RCT（p=0.010；HR0.121，95％CI0.024-0.598）；女性昏迷（p=0.042；HR0.569，95％CI0.0.0.8330％分别。
结论：新辅助RCT术后复发肿瘤患者入院时手术切缘阳性的患者，似乎存在局部失败的风险增加。化疗强度影响DSS，但不影响OS，这可能是由于接受MAP的年轻患者。
方法：对术前放疗联合3个周期的丝裂霉素/多柔比星/顺铂（MAP）或2-4个周期的多柔比星/顺铂（AP）进行手术治疗的患者进行回顾性分析。估计生存率，并确定了预后因素。
结果：在1994年至2017年之间，共纳入108例患者。接受MAP和AP的患者的中位年龄分别为43岁和51岁，分别。5年局部无复发生存率（LRFS），无病生存率（DFS），疾病特异性生存率（DSS），总生存率（OS）分别为94.1、63.6、75.3和71.9％，分别。在多变量分析中，确定了重要的预测因素如下：RCT前入院时从头或R1/R2切除的肿瘤（p=0.017；风险比[HR]0.112，95％置信区间[CI]0.019-0.675）和R0切除后RCT（p=0.010；HR0.121，95％CI0.024-0.598）；女性昏迷（p=0.042；HR0.569，95％CI0.0.0.8330％分别。
结论：新辅助RCT术后复发肿瘤患者入院时手术切缘阳性的患者，似乎存在局部失败的风险增加。化疗强度影响DSS，但不影响OS，这可能是由于接受MAP的年轻患者。
