Objective To explore the clinical features, treatment and prognosis of postradiation sarcoma (PUS). Methods The clinical datas of seven patients of postradiation sarcoma from 2004 to 2010 were reviewed in our hospital. Results There were 5 female patients and 2 male patients. Five cases originated from bone tissue and two from soft tissue. The primary tumor included 5 breast carcinoma patients and 2 lymphoma patients. The lesions of S PRSs, whose primary tumor were breast carcinoma, located in the same clavicles. In the 2 lymphomas, one case located in the soft tissue of right upper extremity and another case in left ulna. The latent period for the initial tumor to postradiation sarcoma was from 11 to 17 years, mean 14 years. All the 7 cases were misdiagnosised as other diseases at admission. Six cases accepted surgery, including 3 forequarter amputations and 3 local resections. The histological types were osteosarcoma (three cases), malignant fibrous histiocytoma ( one case) , fibrosarcoma ( one case) , chondrosarcoma (one case) , and spindle cell sarcoma ( one case). Of the 7 patients, 2 survived continuously disease free, 2 have unknown outcome, 3 died from the disease at the follow-up 7, 8 and 26 months. Conclusions Postradiation sarcoma was rare and with grave prognosis, which should be differentiated from the metastatic tumor. The basic treatment was surgery. Radiotherapy and chemotherapy had poor efficacy.%目的 探讨放疗后肉瘤的发病特点、治疗方法和预后.方法 分析我科2004～2010年收治的7例放疗后肉瘤的临床资料,随访患者.结果 7例放疗后肉瘤患者中,男2例、女5例,发生于骨组织5例、发生于软组织2例,原发肿瘤为乳腺癌5例、淋巴瘤2例.5例原发病为乳腺癌的患者,其继发的放疗后肉瘤均发病于乳腺癌同侧的锁骨区.其余2例淋巴瘤患者,1例发病于右上臂软组织,另1例发病于左尺骨远端.从开始接受放疗到肉瘤变时的潜伏期为11 ～ 17 a、平均14 a.7例患者入院诊断时,均被误诊为其他疾病.除1例未行手术外,其余患者行手术治疗.病理结果 3例为骨肉瘤、1例为软骨肉瘤、1例为纤维肉瘤、1例为恶性纤维组织细胞瘤、1例为梭形细胞肉瘤.3例患者于术后7、8、26个月死亡,2例健在,2例失随访.结论 放疗后肉瘤罕见,诊断时需与转移瘤相鉴别,治疗以手术为主,放疗和化疗效果不佳,预后差.
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