Introduction: Soft tissue sarcomas of the extremities (ESTSs) pose significant challenges in treatment and management due to their diverse nature and potential complications. This study aimed to assess complications associated with multimodal treatments involving surgery and radiotherapy (RT) and to identify potential risk factors. Methods: We retrospectively analyzed nonmetastatic ESTS patients treated with surgery and pre- or post-operative RT between 2007 and 2020 in Strasbourg, France. Complications, including wound complications (WCs), lymphedema, acute and chronic RT-related complications, and fractures, were meticulously evaluated. Results: A total of 169 patients diagnosed with localized ESTSs were included, with a median age of 64 years (range 21–94 years). ESTSs primarily occurred proximally (74.6%) and in the lower limbs (71%). The median follow-up was 5.5 years. WCs occurred in 22.5% of patients, with proximal and lower extremity tumors being significant risk factors. Acute RT-related complications included radiodermatitis, with grade ≥ 2 occurring in 43.1% of patients, which was associated with superficial tumors. Three patients had an edema grade ≥ 2. Chronic complications included telangiectasias (21.7%) and fibrosis (38.7%), with higher rates associated with larger PTVs and higher RT doses, respectively. Fractures occurred in 5 patients, mainly in the tibia (40%). Conclusions: Multimodal treatment of ESTSs demonstrated excellent tolerance, with manageable side effects. Numerous risk factors have been highlighted, providing insights for optimizing treatment strategies and enhancing patient care in this rare disease.
引言：肢体软组织肉瘤因其异质性及潜在并发症，在治疗与管理中构成显著挑战。本研究旨在评估手术联合放疗多模式治疗相关并发症，并识别潜在风险因素。方法：我们回顾性分析了2007年至2020年间在法国斯特拉斯堡接受手术联合术前或术后放疗的非转移性肢体软组织肉瘤患者。对伤口并发症、淋巴水肿、急性与慢性放疗相关并发症及骨折等进行了系统评估。结果：共纳入169例局限性肢体软组织肉瘤患者，中位年龄64岁（范围21-94岁）。肿瘤主要发生于肢体近端（74.6%）及下肢（71%），中位随访时间5.5年。伤口并发症发生率为22.5%，近端及下肢肿瘤是其显著风险因素。急性放疗并发症包括放射性皮炎，≥2级发生率为43.1%，与浅表肿瘤相关。3例患者出现≥2级水肿。慢性并发症包括毛细血管扩张（21.7%）和纤维化（38.7%），其发生率分别与较大计划靶区体积和较高放疗剂量相关。5例患者发生骨折，其中胫骨骨折占40%。结论：肢体软组织肉瘤的多模式治疗耐受性良好，副作用可控。研究明确了多项风险因素，为优化这类罕见疾病的治疗策略及提升患者照护水平提供了重要依据。
肿瘤(癌症)患者之家