复发或转移性孤立性纤维瘤的临床诊治策略
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摘要
目的:探讨复发或转移性孤立性纤维瘤(SFT)的临床诊治策略。方法:收集复旦大学附属中山医院2012年1月至2018年10月收治的19例复发或转移性孤立性纤维瘤患者的临床及随访资料,分析局部治疗及药物治疗的疗效。结果:10例患者复发或转移后再次行手术治疗;未手术的患者中,4例采用放射治疗,2例采用介入治疗,3例广泛转移者采用药物治疗(其中1例联合介入治疗)。19例患者随访7～79个月,中位随访43个月;1年总生存率为94.7%(18/19),2年总生存率为73.7%(14/19)。结论:复发或转移性孤立性纤维瘤进展缓慢,以局部复发多见,也可出现远处转移;再次手术疗效可靠,不可切除的患者可采用局部治疗(介入或放疗)联合药物治疗。
Objective: To explore the clinical strategy for treatment for patients with recurrent or metastatic solitary fibrous tumor. Methods: The clinical data and follow-up data of 19 patients with recurrent or metastatic solitary fibrous tumor admitted to Zhongshan Hospital, Fudan University from January 2012 to October 2018 were collected, and the curative effects of local treatment and drug therapy were analyzed. Results: Ten patients underwent operation after recurrence or metastasis. Among the patients without operation, 4 patients were treated with radiotherapy, 2 patients were treated with interventional therapy, and 3 patients with extensive metastasis were treated with drug therapy(1 combined with interventional therapy). Nineteen patients were followed up for 7-79 months, with a median follow-up of 43 months. The 1-year overall survival rate was 94.7%(18/19) and the 2-year overall survival rate was 73.7%(14/19). Conclusions: The progress of recurrent or metastatic solitary fibrous tumor is slow. Local recurrence is common and distant metastasis can also occur. Re-operation has reliable curative effect. Non-resectable patients can be treated with local therapy(interventional or radiotherapy) combined with drug therapy.
Objective: To explore the clinical strategy for treatment for patients with recurrent or metastatic solitary fibrous tumor. Methods: The clinical data and follow-up data of 19 patients with recurrent or metastatic solitary fibrous tumor admitted to Zhongshan Hospital, Fudan University from January 2012 to October 2018 were collected, and the curative effects of local treatment and drug therapy were analyzed. Results: Ten patients underwent operation after recurrence or metastasis. Among the patients without operation, 4 patients were treated with radiotherapy, 2 patients were treated with interventional therapy, and 3 patients with extensive metastasis were treated with drug therapy(1 combined with interventional therapy). Nineteen patients were followed up for 7-79 months, with a median follow-up of 43 months. The 1-year overall survival rate was 94.7%(18/19) and the 2-year overall survival rate was 73.7%(14/19). Conclusions: The progress of recurrent or metastatic solitary fibrous tumor is slow. Local recurrence is common and distant metastasis can also occur. Re-operation has reliable curative effect. Non-resectable patients can be treated with local therapy(interventional or radiotherapy) combined with drug therapy.
引文
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[12] PARK M S,RAVI V,CONLEY A,et al.The role of chemotherapy in advanced solitary fibrous tumors:a retrospective analysis[J].Clin Sarcoma Res,2013,3(1):7.
[13] ZHANG H,LUCAS D R,PASS H I,et al.Disseminated malignant solitary fibrous tumor of the pleura[J].Pathol Int,2004,54(2):111-115.
[14] PARK M S,PATEL S R,LUDWIG J A,et al.Activity of temozolomide and bevacizumab in the treatment of locally advanced,recurrent,and metastatic hemangiopericytoma and malignant solitary fibrous tumor[J].Cancer,2011,117(21):4939-4947.
[15] STACCHIOTTI S,NEGRI T,LIBERTINI M,et al.Sunitinib malate in solitary fibrous tumor (SFT)[J].Ann Oncol,2012,23(12):3171-3179.
[16] GEORGE S,MERRIAM P,MAKI R G,et al.Multicenter phase Ⅱ trial of sunitinib in the treatment of nongastrointestinal stromal tumor sarcomas[J].J Clin Oncol,2009,27(19):3154-3160.
[17] VALENTIN T,FOURNIER C,PENEL N,et al.Sorafenib in patients with progressive malignant solitary fibrous tumors:a subgroup analysis from a phase Ⅱ study of the French Sarcoma Group (GSF/GETO)[J].Invest New Drugs,2013,31(6):1626-1627.
[18] EBATA T,SHIMOI T,BUN S,et al.Efficacy and safety of pazopanib for recurrent or metastatic solitary fibrous tumor[J].Oncology,2018,94(6):340-344.
[19] MARTIN-BROTO J,STACCHIOTTI S,LOPEZ-POUSA A,et al.Pazopanib for treatment of advanced malignant and dedifferentiated solitary fibrous tumour:a multicentre,single-arm,phase 2 trial[J].Lancet Oncol,2019,20(1):134-144.
[20] 何新红,李文涛.软组织肿瘤的介入治疗[J].中国实用外科杂志,2013,33 (2):124-126.
[ 2 ] BRISELLI M,MARK E J,DICKERSIN G R.Solitary fibrous tumors of the pleura:eight new cases and review of 360 cases in the literature[J].Cancer,1981,47 (11):2678- 2689.
[ 3 ] 王路,金星一,郝铮,等.中枢神经系统孤立性纤维瘤/血管周细胞瘤的诊断和治疗[J].中华神经外科杂志,2016,32(11):1104-1108.
[ 4 ] 惠敏,徐源,张宁,等.腹腔孤立性纤维瘤18例临床分析[J].中华医学杂志,2018,98(18):1439-1442.
[ 5 ] MARTIN A J,FISHER C,IGBASEIMOKUMO U,et al.Solitary fibrous tumours of the meninges:case series and literature review[J].J Neurooncol,2001,54(1):57-69.
[ 6 ] POYRAZ A,KILIC D,HATIPOGLU A,et al.Pedunculated solitary fibrous tumours arising from the pleura[J].Monaldi Arch Chest Dis,2006,65(3):165-168.
[ 7 ] DE SAINT AUBAIN SOMERHAUSEN N,RUBIN B P,FLETCHER C D.Myxoid solitary fibrous tumor:a study of seven cases with emphasis on differential diagnosis[J].Mod Pathol,1999,12(5):463-471.
[ 8 ] 杨建宝,冯海明,赵晔,等.全身多发性恶性孤立性纤维性肿瘤1例及相关文献回顾[J].现代肿瘤医学,2017,25(19):3149-3156.
[ 9 ] ROSENBERG A E.WHO Classification of Soft Tissue and Bone,fourth edition:summary and commentary[J].Curr Opin Oncol,2013,25(5):571-573.
[10] KHOWAJA A,JOHNSON-RABBETt B,BANTLE J,et al.Hypoglycemia mediated by paraneoplastic production of Insulin like growth factor-2 from a malignant renal solitary fibrous tumor-clinical case and literature review[J].BMC Endocr Disord,2014,14:49.
[11] RUPPE M D,HUANG S A,JAN DE BEUR S M.Consumptive hypothyroidism caused by paraneoplastic production of type 3 iodothyronine deiodinase[J].Thyroid,2005,15 (12):1369-1372.
[12] PARK M S,RAVI V,CONLEY A,et al.The role of chemotherapy in advanced solitary fibrous tumors:a retrospective analysis[J].Clin Sarcoma Res,2013,3(1):7.
[13] ZHANG H,LUCAS D R,PASS H I,et al.Disseminated malignant solitary fibrous tumor of the pleura[J].Pathol Int,2004,54(2):111-115.
[14] PARK M S,PATEL S R,LUDWIG J A,et al.Activity of temozolomide and bevacizumab in the treatment of locally advanced,recurrent,and metastatic hemangiopericytoma and malignant solitary fibrous tumor[J].Cancer,2011,117(21):4939-4947.
[15] STACCHIOTTI S,NEGRI T,LIBERTINI M,et al.Sunitinib malate in solitary fibrous tumor (SFT)[J].Ann Oncol,2012,23(12):3171-3179.
[16] GEORGE S,MERRIAM P,MAKI R G,et al.Multicenter phase Ⅱ trial of sunitinib in the treatment of nongastrointestinal stromal tumor sarcomas[J].J Clin Oncol,2009,27(19):3154-3160.
[17] VALENTIN T,FOURNIER C,PENEL N,et al.Sorafenib in patients with progressive malignant solitary fibrous tumors:a subgroup analysis from a phase Ⅱ study of the French Sarcoma Group (GSF/GETO)[J].Invest New Drugs,2013,31(6):1626-1627.
[18] EBATA T,SHIMOI T,BUN S,et al.Efficacy and safety of pazopanib for recurrent or metastatic solitary fibrous tumor[J].Oncology,2018,94(6):340-344.
[19] MARTIN-BROTO J,STACCHIOTTI S,LOPEZ-POUSA A,et al.Pazopanib for treatment of advanced malignant and dedifferentiated solitary fibrous tumour:a multicentre,single-arm,phase 2 trial[J].Lancet Oncol,2019,20(1):134-144.
[20] 何新红,李文涛.软组织肿瘤的介入治疗[J].中国实用外科杂志,2013,33 (2):124-126.