目的 探讨放疗后脊柱肉瘤的起因、临床特点、治疗及预后。方法 自1997年以来共收治5例放疗后肉瘤患者,其中4例为脊柱原发性巨细胞瘤术后,1例为何杰金病。均予以肿瘤切除内固定术及术后化疗。结果 术后所有患者的症状均有不同程度的缓解,经2～5年随访,3例死亡,2例复发。结论 脊柱原发性肿瘤的首次手术一定要彻底,同时避免脊柱承受大剂量、长期的X线照射,以尽可能预防放疗后脊柱肉瘤的发生。 Objective To investigate the causes, clinical features, treatment and prognosis of spinal sarcoma after radiotherapy. Methods A total of 5 patients with post-radiotherapy sarcoma were treated since 1997, including 4 cases of primary giant cell tumor of the spine and 1 case of Hodgkin’s disease. All patients underwent tumor resection and internal fixation and postoperative chemotherapy. Results All patients had different degrees of relief after operation. After 2 to 5 years of follow-up, 3 patients died and 2 patients relapsed. Conclusion The first operation of the primary tumor of the spine must be complete, while avoiding the spinal cord to withstand large doses of long-term X-ray irradiation in order to prevent the occurrence of spinal sarcoma after radiotherapy.