Abstract：
Patients with soft tissue sarcoma of the extremities (STSE) are left with high incidence of toxicities after Radiotherapy (RT). Understanding the normal tissue dose relationship with the development of long-term toxicities may enable better RT planning in order to reduce treatment toxicities for STSE. This systematic review of the literature aims at reporting the incidence of acute and late toxicities and identifying RT delineation guidance the normal tissues structures and dose-volume parameters for STSE.
A literature search of PUBMED-MEDLINE for studies that reported data on RT toxicity outcomes, delineation guidelines and dose-volume parameters for STSE from 2000 to 2022. Data has been tabulated and reported.
Thirty of 586 papers were selected after exclusion criteria. External beam RT prescriptions ranged from 30 to 72 Gy. The majority of studies reported the use of Intensity Modulated RT (IMRT) (27%). Neo-adjuvant RT was used in 40%. The highest long-term toxicities were subcutaneous and lymphoedema, reported when delivering 3DCRT. IMRT had a lower incidence of toxicities. Normal tissue outlining such as weight-bearing bones, skin and subcutaneous tissue, corridor and neurovascular bundle was recommended in 6 studies. Nine studies recommended the use of dose-volume constraints, but only one recommended evidence-based dose-volume constraints.
Although the literature is replete with toxicity reports, there is a lack of evidence-based guidance on normal tissue and dose-volume parameters and strategies to reduce the normal tissues irradiation when optimising RT plans for STSE are poor compared to other tumour sites.
A literature search of PUBMED-MEDLINE for studies that reported data on RT toxicity outcomes, delineation guidelines and dose-volume parameters for STSE from 2000 to 2022. Data has been tabulated and reported.
Thirty of 586 papers were selected after exclusion criteria. External beam RT prescriptions ranged from 30 to 72 Gy. The majority of studies reported the use of Intensity Modulated RT (IMRT) (27%). Neo-adjuvant RT was used in 40%. The highest long-term toxicities were subcutaneous and lymphoedema, reported when delivering 3DCRT. IMRT had a lower incidence of toxicities. Normal tissue outlining such as weight-bearing bones, skin and subcutaneous tissue, corridor and neurovascular bundle was recommended in 6 studies. Nine studies recommended the use of dose-volume constraints, but only one recommended evidence-based dose-volume constraints.
Although the literature is replete with toxicity reports, there is a lack of evidence-based guidance on normal tissue and dose-volume parameters and strategies to reduce the normal tissues irradiation when optimising RT plans for STSE are poor compared to other tumour sites.
摘要：
背景：四肢软组织肉瘤（STSE）患者在放疗（RT）后的毒性发生率很高。了解正常组织剂量与长期毒性发展的关系可能有助于更好的RT计划，以减少STSE的治疗毒性。这篇系统的文献综述旨在报告急性和晚期毒性的发生率，并确定RT描绘指导STSE的正常组织结构和剂量体积参数。
方法：对PUBMED-MEDLINE进行文献检索，以获取报道RT毒性结果数据的研究，2000年至2022年STSE的划界指南和剂量体积参数。数据已经列表和报告。
结果：按照排除标准选择586篇论文中的30篇。外部光束RT处方范围为30至72Gy。大多数研究报告使用强度调节RT(IMRT)(27%)。新佐剂RT以40%使用。最高的长期毒性是皮下和淋巴水肿，在交付3DCRT时报告。IMRT的毒性发生率较低。正常组织轮廓，如负重骨骼，皮肤和皮下组织，6项研究推荐走廊和神经血管束.九项研究建议使用剂量体积限制，但只有一个推荐的基于证据的剂量体积限制。
结论：尽管文献中有大量的毒性报道，与其他肿瘤部位相比,在优化STSE的RT计划时,缺乏对正常组织和剂量-体积参数的循证指导以及减少正常组织照射的策略。
方法：对PUBMED-MEDLINE进行文献检索，以获取报道RT毒性结果数据的研究，2000年至2022年STSE的划界指南和剂量体积参数。数据已经列表和报告。
结果：按照排除标准选择586篇论文中的30篇。外部光束RT处方范围为30至72Gy。大多数研究报告使用强度调节RT(IMRT)(27%)。新佐剂RT以40%使用。最高的长期毒性是皮下和淋巴水肿，在交付3DCRT时报告。IMRT的毒性发生率较低。正常组织轮廓，如负重骨骼，皮肤和皮下组织，6项研究推荐走廊和神经血管束.九项研究建议使用剂量体积限制，但只有一个推荐的基于证据的剂量体积限制。
结论：尽管文献中有大量的毒性报道，与其他肿瘤部位相比,在优化STSE的RT计划时,缺乏对正常组织和剂量-体积参数的循证指导以及减少正常组织照射的策略。
