背景:很少有研究比较手术治疗和粒子束治疗的骨盆骨肉瘤患者的临床结果。这是一项多中心回顾性队列研究,比较了在日本接受手术治疗和粒子束治疗的骨盆骨肉瘤患者的临床结果。
方法:本研究纳入了在日本19个专门的肉瘤中心治疗的116例骨盆骨肉瘤患者。57例患者接受了手术(手术组),59例患者接受了粒子束治疗(粒子束组;碳离子放射治疗:55例患者,质子:四名患者)。
结果:手术组原发性肿瘤诊断的中位年龄为52岁,粒子束组66岁(P<0.001),手术组的中位肿瘤大小为9cm,粒子束组的中位肿瘤大小为8cm(P=0.091)。总生存期(OS),本地控制(LC),使用Kaplan-Meier方法评估无转移生存率(MFS),并在116例骨肉瘤患者中进行比较(手术组,57例患者;粒子束组,59名患者)。在倾向得分匹配后,3年操作系统,LC,MFS率为82.9%(95%置信区间[CI],60.5-93.2%),66.0%(95%CI,43.3-81.3%),和78.4%(95%CI,55.5-90.5%),分别,手术组为64.9%(95%CI,41.7-80.8%),86.4%(95%CI,63.3-95.4%),和62.6%(95%CI,38.5-79.4%),分别,在粒子束组中。在脊索瘤患者中,在单因素分析中,只有手术与较差的LC显著相关.
结论:两组的OS无显著差异,LC,和MFS费率。在脊索瘤患者中,粒子束组的3年LC率明显高于手术组。
BACKGROUND: Few studies have compared the clinical outcomes of patients with pelvic bone sarcomas treated surgically and those treated with particle beam therapy. This is a multicenter retrospective cohort study which compared the clinical outcomes of patients with pelvic bone sarcoma who underwent surgical treatment and particle beam therapy in Japan.
METHODS: A total of 116 patients with pelvic bone sarcoma treated at 19 specialized sarcoma centers in Japan were included in this study. Fifty-seven patients underwent surgery (surgery group), and 59 patients underwent particle beam therapy (particle beam group; carbon-ion radiotherapy: 55 patients, proton: four patients).
RESULTS: The median age at primary tumor diagnosis was 52 years in the surgery group and 66 years in the particle beam group (P < 0.001), and the median tumor size was 9 cm in the surgery group and 8 cm in the particle beam group (P = 0.091). Overall survival (OS), local control (LC), and metastasis-free survival (MFS) rates were evaluated using the Kaplan-Meier method and compared among 116 patients with bone sarcoma (surgery group, 57 patients; particle beam group, 59 patients). After propensity score matching, the 3-year OS, LC, and MFS rates were 82.9% (95% confidence interval [CI], 60.5-93.2%), 66.0% (95% CI, 43.3-81.3%), and 78.4% (95% CI, 55.5-90.5%), respectively, in the surgery group and 64.9% (95% CI, 41.7-80.8%), 86.4% (95% CI, 63.3-95.4%), and 62.6% (95% CI, 38.5-79.4%), respectively, in the particle beam group. In chordoma patients, only surgery was significantly correlated with worse LC in the univariate analysis.
CONCLUSIONS: The groups had no significant differences in the OS, LC, and MFS rates. Among the patients with chordomas, the 3-year LC rate in the particle beam group was significantly higher than in the surgery group.