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7.P.40 TO THE QUESTION OF OPTIMIZATION OF TREATMENT OF MALIGNANT FIBROHISTIOCYTIC TUMOR OF SOFT TISSUES



Abstract

Aim of the research: generalization and optimization of methods of treatment of patient’s with fibrohistiocytic tumor of soft tissues.

Materials and methods: There were 79 (100%) patients under observation with malignant fibrohistiocytic tumor of soft tissue in the period from 2000 to 2006 year. There were 41 (51,9%) male and 38 (48,1%) female patients. The average age of patients were 45,5. Depending on localization of tumor on the lower extremities 47 (59,4%), on the upper extremities 19 (24%), trunk 13 (16,5%) of patients. Depending on histological structure of tumor the patients were distributed in the following way: 69 (87,3%) malignant fibrous histiocytoma, 10 (12,6%) atypical fibroxanthoma. In 49 (6,2%) cases were the initial tumor, at 30 (37%) were relapse tumor. In diagnostic used complex methods with including into investigation rentgenography, echography, USM, KT and MRT and morphological methods of research. The main methods of treatment are surgical, combine and complex. In initial and localized processes (the size of tumor < 5 cm) the main method is surgical (wide carving of tumor). The additional treatments to these patients did not make and they released under dynamic control. In our case there were 24 (30,4%) such kind of patients. In size of tumor from 5 to 10cm, and also in relapse at 17 (21,5%) patients on the first stage made surgical intervention, and then got distance gamma therapy (SOD 50Gy). In postoperative period conducted chemotherapy to 6 (7,5%) patients. In size of tumor more than 10cm in localization in upper extremities and trunk at 5(6,3%) patients the treatment begins with RT, and then surgical intervention +PXT by diagram CAPO, MAID, CAV II and others. In localization on lower extremities at 3 (3,8%) patients treatment begins with intra-arterial infusion Doxorubicin hydrochloride in 30mg/m2 during for 3 days (90mg/m2) and then surgical intervention +RT 50 Gy. At 18 (22,8%) patients were carving relapse, at 9 (11,5%) amputation, at 4 (5,1%) patients were exarticulation.

Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de