【摘要】 目的探讨术前辅助放疗联合扩大根治术治疗四肢高度恶性软组织肉瘤的疗效。方法根据治疗方案将174例四肢高度恶性组织肉瘤患者分为观察组89例和对照组85例,观察组采用术前辅助放疗联合扩大根治术方案治疗,对照组采用扩大根治术联合术后辅助放疗方案治疗,现比较两组患者的近期疗效及远期疗效。结果观察组R0切除率、切口愈合时间、保肢率、5年生存率显著优于对照组,而放射性皮炎发生率、术后淋巴水肿程度、复发率、转移率显著低于对照组,差异有统计学意义(P <0. 01)。两组患者切口愈合率、切口感染率比较差异无统计学意义(P> 0. 05)。结论术前辅助放疗联合扩大根治术治疗四肢恶性软组织肉瘤有助于提高R0切除率,降低并发症风险并改善远期预后,值得在临床推广。更多还原

【Abstract】 Objective To explore the efficacy of preoperative adjuvant radiotherapy plus extensive radical mastectomy in the treatment of malignant soft tissue sarcoma of extremities. Methods 174 cases of malignant soft tissue sarcoma of extremities were divided into the observation group( 89 cases) and the control group( 85 cases) according to their therapeutic regimens,and the former received preoperative adjuvant radiotherapy plus extensive radical mastectomy,while the latter received extensive radical mastectomy plus postoperative adjuvant radiotherapy,the short-term efficacy and long-term efficacy were compared between the 2 groups. Results The R0 resection rate,healing time of incision,limb salvage rate and 5-year survival rate of the observation group were obviously higher than those of the control group,while the incidence of radiation dermatitis,postoperative lymphedema,recurrence rate and metastasis rate were lower than those of the control group( P < 0. 01). There were no obvious differences in the healing rate and infection rate of incision between the 2 groups( P > 0. 05). Conclusion The preoperative adjuvant radiotherapy plus extensive radical mastectomy for malignant soft tissue sarcoma of extremities contributes to improve the R0 resection rate,reduce the risk of complications and improve the long-term prognosis,which is worthy of being popularized clinically.更多还原