A retrospective cohort study on postoperative radiotherapy and postoperative chemoradiotherapy for soft tissue sarcomas
10.3760/cma.j.cn113030-20230605-00162
- VernacularTitle:软组织肉瘤术后放疗与术后放化疗比较的回顾性队列研究
- Author:
Zhilei LI
1
;
Li XU
;
Jinwen SHEN
;
Ning ZHOU
;
Na ZHANG
;
Peng LIU
;
Ke LU
;
Dong LIU
;
Quanquan SUN
;
Yanru FENG
;
Luying LIU
;
Yuan ZHU
;
Jialin LUO
Author Information
1. 温州医科大学研究生培养基地（浙江省肿瘤医院），中国科学院杭州医学研究所，杭州310022
- Keywords:
Soft tissue neoplasms;
Postoperative radiotherapy;
Postoperative chemoradiotherapy
- From:
Chinese Journal of Radiation Oncology
2023;32(12):1057-1063
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the differences in clinical outcomes and toxicities between postoperative radiotherapy alone and postoperative radiochemotherapy for soft tissue sarcoma (STS), as well as the related factors affecting clinical prognosis of STS patients.Methods:Retrospective analysis of patients diagnosed with primary STS admitted to Zhejiang Cancer Hospital from May 2012 to May 2019 was performed, who received adjuvant radiotherapy after surgery, combined with or without postoperative chemotherapy. A total of 100 patients were enrolled and divided into postoperative radiotherapy group ( n=52) and postoperative radiochemotherapy group ( n=48). The median follow-up time was 65 months (24-124 months). The local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-related toxicities were recorded in two groups. The survival rate was calculated by Kaplan-Meier analysis. Log-rank test was used for univariate analysis, and Cox model was used for multivariate analysis. Results:In multivariate analysis, the maximum tumor diameter was an independent predictor of local tumor recurrence ( HR=4.80, 95% CI=1.16-19.85, P=0.031), distant metastasis ( HR=4.67, 95% CI=1.53-14.26, P=0.007) and OS ( HR=4.10, 95% CI=1.35-12.48, P=0.013). In addition, the degree of myelosuppression in patients in postoperative radiochemotherapy was significantly higher than that in their counterparts in postoperative radiotherapy group ( P<0.001). Conclusions:In the limited number of patients, radiochemotherapy has no advantages over radiotherapy alone in distant metastasis or survival rate. Besides, it increases toxicities, but the overall tolerability is favorable. It is necessary to conduct prospective randomized studies in a large population and subgroup analysis of histological subtypes, aiming to obtain results with better reference value.
