肢体脂肪肉瘤的预后相关因素及放化疗疗效分析  

Analysis of prognostic factors and the effect of adjuvant radiotherapy and chemotherapy for liposarcoma of the extremities

作　　者：刘佳勇[1] 方志伟[1] 樊征夫[1] 陈飞[1] 白楚杰[1] 薛瑞峰[1] 李舒[1] 张路[1] 高天[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所骨与软组织肿瘤科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142

出　　处：《中国肿瘤临床》2015年第6期351-356,共6页Chinese Journal of Clinical Oncology

摘　　要：目的：统计分析肢体脂肪肉瘤的临床预后相关因素；回顾性分析辅助放疗、化疗对脂肪肉瘤的治疗效果。方法：随访2007年7月至2012年12月在北京大学肿瘤医院接受综合治疗的肢体脂肪肉瘤患者，统计分析预后与年龄、部位、入院状态等临床因素的关系。分析辅助放疗和化疗对总生存时间（overall survival，OS）和无病生存时间（disease free survival，DFS）的影响。结果：共82例患者接受手术为主的综合治疗，失访9例，73例患者获得随访，随访时间24～88个月，中位随访时间47个月。总生存率为83.6%（61/73），无病生存率为68.5%（50/73）。Cox多因素回归分析提示部位、病理分级和入院状态是影响DFS的独立相关因素；年龄和病理分级是影响OS的独立相关因素。Kaplan-Meier生存分析显示，放疗能够显著改善G2、G3级脂肪肉瘤的DFS（59.1个月vs.28.4个月，P〈0.01），并且能改善OS（70.8个月vs.55.1个月，P〈0.05）。结论：脂肪肉瘤的预后与患者年龄、部位及病理分级相关。辅助放疗可改善G2、G3级肢体脂肪肉瘤的生存与预后，但化疗在脂肪肉瘤治疗中的作用尚不明确。Objective：To analyze the clinical prognostic factors of liposarcoma on the extremities and trunk, as well as to retrospectively analyze the effect of adjuvant radiotherapy and chemotherapy on liposarcoma of the extremities. Methods：Patients with liposarcoma of the extremities treated in our hospital from July 1, 2007 to December 31, 2012 were followed up. The relationship of clinical prognostic factors with gender, age, location, depth, and size of the tumors, as well as the histological grade and admission status, were statistically analyzed. The effects of adjuvant radiotherapy or chemotherapy on overall survival （OS） and disease free survival （DFS） were evaluated. Results：A total of 82 patients with extremity liposarcoma received surgery-based comprehensive treatment in our hospital. Of the total patients, 73 received a 24-month to 88-month satisfied follow-up;the median follow-up time was 47 months. The OS rate was 83.6%（61/73）, and the DFS rate was 68.5%（50/73）. Multivariate Cox regression analysis showed that the tumor location, histological grade, and admission status were the independent correlative factors influencing DFS, and the age and pathologic grading were the independent correlative factors influencing the OS. Kaplan-Meier survival analysis showed that radiation therapy can significantly improve the DFS and OS of the G2 and G3-grade liposarcoma （DFS：59.1 months vs. 28.4 months, P〈0.01;OS：70.8 months vs. 55.1 months, P〈0.05）. Significant difference was not found in the effect of chemotherapy on OS and DFS. Conclusion：The prognosis of liposarcoma was significantly associated with the pathologic grades and subtypes. Auxiliary radiotherapy could improve the survival and prognosis of G2 and G3 liposarcoma of the extremities, but the role of chemotherapy in treating liposarcoma remained unclear.

关 键 词：脂肪肉瘤 预后因素 放疗 化疗 总生存时间 无病生存时间 

分 类 号：R739.96[医药卫生—肿瘤]