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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2016, Vol. 25 Issue (10): 1092-1095    DOI: 10.3760/cma.j.issn.1004-4221.2016.10.015
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血管肉瘤临床单中心治疗分析
张敏,高献书,马茗微,李晓颖,亓昕,李洪振,刘凌,秦尚彬,于世平,周刚
100034 北京大学第一医院放疗科
Treatment of angiosarcoma at a single institution
Zhang Min,Gao Xianshu,Ma Mingwei,Li Xiaoying,Qi Xin,Li Hongzhen,Liu Ling,Qin Shangbin,Yu Shiping,Zhou Gang
Department of Radiation Oncology,Peking Univercity First Hospital,Beijing 100034,China
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摘要  目的 分析血管肉瘤治疗后的生存情况及影响预后的因素。方法 回顾分析1988—2015年间本院收治的经病理证实有完整随访资料的30例血管肉瘤患者资料。综合治疗18例,其中手术+放疗9例、手术+放疗+化疗4例、手术+化疗5例;非综合治疗12例,其中单纯手术11例、单纯放疗1例。Kaplan-Meier法计算生存率并Logrank法检验,Cox模型多因素预后分析。结果 1、2、5年样本量分别为29、26、18例。1、2、5年OS率分别为70.1%、49.1%、40.9%,LRFS率分别为52.8%、44.0%、35.2%,DMFS率分别为81.6%、68.0%、56.7%。单因素分析显示发病部位、肿瘤大小、分期、初次治疗后有无肉眼肿瘤残留与OS相关(P=0.027、0.027、0.011、0.000);Ⅰ、Ⅱ期患者综合治疗较单一治疗者LR率低(P=0.006);性别、年龄、分期、发病部位与DM相关(P=0.028、0.011、0.015、0.022)。结论 血管肉瘤LR和DM率高预后差,应早诊断、早治疗;对Ⅰ、Ⅱ期患者也应进行综合治疗(手术+放疗±化疗),预后因素包括发病部位、肿瘤大小、分期、初次治疗后有无肉眼肿瘤残留。
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张敏
高献书
马茗微
李晓颖
亓昕
李洪振
刘凌
秦尚彬
于世平
周刚
关键词 血管肉瘤/外科学 血管肉瘤/放射疗法 血管肉瘤/化学疗法 预后    
Abstract: Objective To analyze the survival and prognostic factors in the treatment of angiosarcoma. Methods A retrospective study was performed on clinical data of 30 patients pathologically diagnosed with angiosarcoma who were admitted to our hospital from 1988 to 2015 and had complete follow-up data. In those patients, 18 patients received comprehensive treatment, containing 9 patients treated with surgery plus radiotherapy, 4 patients with surgery plus chemoradiotherapy, and 5 with surgery plus chemotherapy;12 patients received non-comprehensive treatment, containing 11 patients treated with surgery alone and 1 patient radiotherapy alone. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. The Cox regression model was used for multivariate prognostic analyses. Results The 1-, 2-, and 5-year sample sizes were 29,26, and 18, respectively. The 1-, 2-, and 5-year overall survival (OS) rates were 70.1%, 49.1%, and 40.9%, respectively;the 1-, 2-, and 5-year local relapse-free survival rates were 52.8%, 44.0%, and 35.2%, respectively;the 1-, 2-, and 5-year distant metastasis-free survival rates were 81.6%, 68.0%, and 56.7%, respectively. The multivariate analysis showed that tumor site, tumor size, staging, and visible tumor residue after initial treatment were prognostic factors for OS (P=0.027,0.027,0.011,0.000);In the patients with stage Ⅰ or Ⅱ disease, the comprehensive treatment achieved a significantly lower local-relapse rate than the individual treatment (P=0.006);gender, age, staging, and tumor site were prognostic factors for distant metastasis (P=0.028,0.011,0.015,0.022). Conclusions Early diagnosis and early treatment are recommended for angiosarcoma, which has high local recurrence and distant metastasis rates. Comprehensive treatment (surgery plus radiotherapy and/or chemotherapy) is recommended for patients with stage Ⅰ or Ⅱ disease. Tumor site, tumor size, staging, and visible tumor residue after initial treatment are prognostic factors.
Key words Angiosarcomas/surgery    Angiosarcomas/radiotherapy    Angiosarcomas/chemotherapy    Prognosis   
收稿日期: 2016-02-05     
通讯作者: 高献书,Email:13911208977@139.com   
引用本文:   
张敏,高献书,马茗微等. 血管肉瘤临床单中心治疗分析[J]. 中华放射肿瘤学杂志, 2016, 25(10): 1092-1095.
Zhang Min,Gao Xianshu,Ma Mingwei et al. Treatment of angiosarcoma at a single institution[J]. Chinese Journal of Radiation Oncology, 2016, 25(10): 1092-1095.
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