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中华疝和腹壁外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (04) : 377 -382. doi: 10.3877/cma.j.issn.1674-392X.2025.04.003

所属专题: 文献

腹膜后肿瘤专题综述

围手术期放射治疗在可切除腹膜后肉瘤治疗中的价值
徐燕楠, 胡成宇, 花荣()   
  1. 200127 上海交通大学医学院附属仁济医院胆胰外科
  • 收稿日期:2025-06-02 出版日期:2025-08-18
  • 通信作者: 花荣

The value of perioperative radiotherapy in the treatment of resectable retroperitoneal sarcoma

Yannan Xu, Chengyu Hu, Rong Hua()   

  1. Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • Received:2025-06-02 Published:2025-08-18
  • Corresponding author: Rong Hua
引用本文:

徐燕楠, 胡成宇, 花荣. 围手术期放射治疗在可切除腹膜后肉瘤治疗中的价值[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(04): 377-382.

Yannan Xu, Chengyu Hu, Rong Hua. The value of perioperative radiotherapy in the treatment of resectable retroperitoneal sarcoma[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(04): 377-382.

自发现腹膜后肉瘤(RPS)以局部复发为主要进展方式以来,放射治疗(简称"放疗")已成为其重要的辅助治疗手段。最近的技术进展,如影像引导放疗、调强放疗和质子治疗,使得放疗在RPS中的应用更加有效,改善了靶区的精准性和对正常组织的保护能力。本文围绕围手术期放疗在可切除RPS治疗中的应用,分别探讨了术前、术中及术后放疗的适应证、疗效及技术优化策略。研究表明,术前放疗能显著提升局部控制率,在特定组织学类型中尤其明显,而术后放疗的应用存在争议,需谨慎评估其利弊。故而讨论了术中放疗和大分割放疗的潜力,以及未来放疗与全身治疗相结合的前景,以优化腹膜后肉瘤的治疗策略,提高患者的预后。

Retroperitoneal sarcomas (RPS) are characterized by a predominant progressive- pattern of local recurrence, making radiotherapy a cornerstone of adjuvant management. Advances in radiation delivery—such as image-guided radiotherapy, intensity-modulated radiotherapy and proton therapy—have significantly enhanced therapeutic precision, enabling improved tumor targeting while minimizing collateral damage to adjacent tissue. This review investigates the value of perioperative radiotherapy for resectable RPS, focusing on the indications, efficacy, and technical optimization strategies. Studies indicate that preoperative radiotherapy significantly improves local control rates, with varying efficacy across histological subtypes, whereas the benefits of postoperative radiotherapy remain controversial and require careful risk-benefit evaluation. In addition, we explore the potential advantages of intraoperative radiotherapy and hypofractionated regimens, as well as forecast the future prospects for integrating radiotherapy with systemic therapies, aiming to optimize RPS management and improve patient prognosis.

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