罕见软组织肉瘤姑息放疗后的剂量化疗:透视放疗与免疫反应

IF 0.6 Q4 ONCOLOGY Indian Journal of Surgical Oncology Pub Date : 2024-12-01 Epub Date: 2024-05-25 DOI:10.1007/s13193-024-01966-2
Irappa V Madabhavi, Malay S Sarkar, Raghavendra D Sagar
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引用次数: 0

摘要

软组织肉瘤(STS)占人类恶性肿瘤总发病率的 1%以下。转移性STS的治疗目的是缓解症状,预后不佳。本研究旨在评估低剂量放疗和低剂量口服节律疗法在重度预处理转移性少见 STS 中的作用。本研究在一家三级医疗中心以前瞻性观察方式进行。共有16个病例符合研究组的纳入标准。所有亚型的STS均通过组织病理学、免疫组化或细胞遗传学研究确诊。所有入组的转移性 STS 患者均接受了手术和两线化疗,并根据患者的 ECOG 表 现状态,接受了 20 Gy 分 5 次或 30 Gy 分 10 次的低剂量放疗。在 16 名患者中,7 名患者(43.75%)接受了 20 Gy 5 次分次放疗,9 名患者(56.25%)接受了 30 Gy 10 次分次放疗。在 16 例患者中,4 例为恶性纤维组织细胞肉瘤,3 例为血管肉瘤,3 例为乳腺恶性植物瘤,2 例为纤维肉瘤,以及以下亚型各 1 例患者:炎性肌母细胞瘤、亮肌肉瘤、滑膜肉瘤和真皮纤维肉瘤突起。在 16 名患者中,7 人(43.75%)有部分反应(PR),9 人(56.25%)在 3 个月时病情稳定(SD),所有患者在 6 个月评估时病情稳定(SD)。与注射化疗期间相比,所有患者的生活质量都有所提高。有针对性的低剂量放疗和节律化疗会在局部肿瘤微环境中产生可量化的抗血管生成效应和免疫效应,并影响循环免疫介质和抗血管生成,这可能有助于根除放疗区域内外的疾病。
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Metronomic Chemotherapy After Palliative Radiotherapy in Rare Soft Tissue Sarcomas: An Insight into Radiation Therapy and the Immune Response.

Soft tissue sarcomas (STSs) account for less than 1% of the overall human burden of malignant tumors. The intent of treatment in metastatic STSs is palliative and prognosis is dismal. This study aims to evaluate the role of low-dose radiotherapy and low-dose oral metronomic therapy in heavily pretreated metastatic infrequent STSs. This study was conducted in a prospective observational manner in a tertiary care center. A total of 16 cases met the inclusion criteria for enrollment in the study group. The diagnosis of all subtypes of STS was confirmed by histopathology and immunohistochemistry or cytogenetic studies. All the enrolled patients with metastatic STSs who were treated with surgery and two lines of chemotherapy were initially treated with low-dose radiotherapy of 20 Gy in 5 fractions or 30 Gy in 10 fractions according to the ECOG performance status of the patient. Out of 16 patients, seven patients (43.75%) were treated with 20 Gy, 5#, and 9 patients (56.25%) were treated with 30 Gy, 10# radiotherapy (RT). Out of 16 patients, four were of malignant fibrohistiocytic sarcoma, three were angiosarcoma, three were malignant phylloides tumor of the breast, two were fibrosarcoma, and one patient from each of the following subtypes inflammatory myofiroblastic tumor, leiomyosarcoma, synovial sarcoma, and dermato fibrosarcoma protuberance. Out of 16 patients, seven (43.75%) had a partial response (PR), nine (56.25%) had stable disease (SD) at 3 months, and all the patients had SD at 6 months of evaluation. All the patients had enjoyed a better quality of life as compared to their life during injectable chemotherapy. Targeted low-dose radiation and metronomic chemotherapy leads to quantifiable antiangiogeneic effects and immune effects in the local tumor microenvironment, and influences circulating immune mediators and anti-angiogenesis that could potentially help eradicate disease both within and outside the radiation treatment field.

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期刊介绍: The Indian Journal of Surgical Oncology aims to encourage and promote clinical and research activities pertaining to Surgical Oncology. It also aims to bring in the concept of multidisciplinary team approach in management of various cancers. The Journal would publish original article, point of technique, review article, case report, letter to editor, profiles of eminent teachers, surgeons and instititions - a short (up to 500 words) of the Cancer Institutions, departments, and oncologist, who founded new departments.
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