Introduction: Radiation-induced soft tissue sarcomas (RISs) are rare secondary malignancies with a dire prognosis. The literature on the management of these tumors remains scarce due to their low incidence. Our systematic review sought to assess the treatment alternatives and outcomes of patients with RIS. Methods: A systematic review was conducted following the PRISMA guidelines. Our study was registered in PROSPERO (ID: CRD42023438415). Quality assessment was performed using the STROBE checklist. Weighted means for both continuous and categorical values were calculated. Results: Twenty-one studies comprising 1371 patients with RIS were included. The mean latency period from radiation to RIS diagnosis was 14 years, and the mean radiation dose delivered to the primary malignancy was 29.2 Gy. The most common histological type was undifferentiated pleomorphic sarcoma (42.2%), and 64% of all tumors were high-grade. The trunk was the most common location (59%), followed by extremities (21%) and pelvis (11%). Surgery was performed in 68% of patients and, among those with an appendicular tumor, the majority (74%) underwent limb-salvage surgery. Negative margins were attained in 58% of patients. Chemotherapy and radiotherapy were administered in 29% and 15% of patients, respectively. The mean 5-year overall survival was 45%, and the local recurrence and metastasis rates were 39% and 27%, respectively. Conclusions: In our study, the most common treatment was surgical resection, with RT and chemotherapy being administered in less than one third of patients. Patients with RIS exhibited poor oncologic outcomes. Future studies should compare RIS with de novo STS while controlling for confounders.
引言：放射诱发性软组织肉瘤（RIS）是一种罕见的继发性恶性肿瘤，预后极差。由于发病率低，关于此类肿瘤治疗的文献仍然匮乏。本系统综述旨在评估RIS患者的治疗选择及预后。方法：按照PRISMA指南进行系统综述，研究已在PROSPERO平台注册（ID：CRD42023438415）。采用STROBE清单进行质量评估，并计算连续变量和分类变量的加权平均值。结果：共纳入21项研究，涉及1371例RIS患者。从放射治疗到RIS诊断的平均潜伏期为14年，原发恶性肿瘤的平均放射剂量为29.2 Gy。最常见的组织学类型为未分化多形性肉瘤（42.2%），64%的肿瘤为高级别。躯干是最常见的发病部位（59%），其次为四肢（21%）和骨盆（11%）。68%的患者接受了手术治疗，其中肢体肿瘤患者多数（74%）接受了保肢手术。58%的患者实现了切缘阴性。分别有29%和15%的患者接受了化疗和放疗。平均5年总生存率为45%，局部复发率和转移率分别为39%和27%。结论：本研究中，手术切除是最常见的治疗方式，接受放疗和化疗的患者不足三分之一。RIS患者肿瘤学预后较差。未来研究应在控制混杂因素的前提下，将RIS与原发性软组织肉瘤进行比较。
肿瘤(癌症)患者之家