The Anatomy of Sartorius Muscle and its Implications for Sarcoma Radiotherapy

[摘要] Purpose: Controversy exists as to whether sartorius muscle is completely invested in fascia. If it is, then direct tumourinvolvement from soft tissue sarcoma of the anterior thigh would be unlikely and would justify omitting sartorius from theradiotherapy volume.Subjects and methods: Eight thighs in six cadavers were examined in the dissecting room. Using a previous case, conformalradiotherapy plans were prepared to treat the anterior compartment of the thigh including and excluding sartorius. Thecorridor of unirradiated normal tissue was outlined separately.Results: In all cases, sartorius was enclosed within a fascial sheath of its own. In four of the six cadavers, there was clearevidence of a fascial envelope surrounding sartorius, fused to the fascia lata and medial intermuscular septum. In two,sartorius was fully ensheathed in the upper half of the thigh; in the lower half the intermuscular septum becamethin, and blended with the tendinous aponeurosis on the surface of vastus medialis in an example case. By excludingsartorius, the volume of the anterior compartment was reduced by 8%, but the volume of the unirradiated normal tissuecorridor increased by 134%. With sartorius included, the unirradiated corridor became very small inferiorly, only 6% of thecircumference of the whole leg, compared to 27% with sartorius excluded.Discussion: The anatomy suggests that sartorius could be safely omitted from the clinical target volume of anteriorcompartment soft tissue sarcomas. This substantially increases the size of the unirradiated normal tissue corridor, expressedas a volume and a circumference, which could give a clinical advantage by reducing normal tissue complications.

[学科分类] 肿瘤学