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分析本院收治的原发于肢体的软组织肉瘤的治疗情况 ,评价术后放射治疗的作用。方法 本院共收治 15 1例 ,可供分析的 139例 ,分析影响生存和局控的因素及术后放射治疗的意义。生存率和局控率用Kaplan Meier方法计算 ,单因素分析用Logrank检验 ,多因素分析用Cox回归方法。结果 全组 5年生存率为 70 .2 % ,10年为 5 0 .4% ;5年无瘤生存率为 5 2 .9% ,10年为41.2 %。单因素分析对全组病例生存率有影响的因素 :肿瘤大小、年龄和治疗方式 (P值分别为0 .0 0 8,0 .0 0 7和 0 .0 40 )。多因素分析只有治疗方式对生存有影响 (P =0 .0 40 )。首次治疗方式对局控影响差异有极显著性 (P <0 .0 1)。手术方式对单纯手术组局控影响差异有极显著性 (P <0 .0 1) ;肿瘤 <5cm时 ,射野大小对术后放射治疗组局控影响差异有极显著性 (P <0 .0 1)。结论 术后放射治疗能提高局部控制率 ,初始射野应相对大 ,并采用缩野技术。对恶性度低、肿瘤 <5cm、手术切缘阴性患者第 1次术后可不做放射治疗。
Analyze the treatment of primary soft tissue sarcoma treated in our hospital and evaluate the role of postoperative radiotherapy. Methods A total of 151 cases were treated in our hospital and 139 cases were available for analysis. The factors affecting survival and local control and the significance of postoperative radiotherapy were analyzed. The survival rate and local control rate were calculated using the Kaplan Meier method. The univariate analysis was performed using the Logrank test and the multivariate analysis was performed using the Cox regression method. Results The 5-year survival rate was 70.2% in the whole group and 50.4% in 10 years. The 5-year disease-free survival rate was 52.9% and 41.2% in 10 years. Univariate analysis of the factors affecting the survival rate of the entire group of patients: tumor size, age, and treatment (P values were 0.008, 0.007, and 0.04, respectively). Multivariate analysis only had treatment effects on survival (P = .040). The effect of the first treatment on regional control was significantly different (P < 0.01). The effect of surgery on the local control of the surgery group was significantly different (P < 0.01). When the tumor was <5cm, the impact of the size of the injection field on the postoperative radiotherapy group had a significant difference (P <0. 0 1). Conclusion Postoperative radiotherapy can increase the local control rate, the initial field should be relatively large, and the use of shrinkage techniques. For patients with low malignancy, tumors <5cm, negative surgical margins, no radiotherapy was performed after the first operation.