肢体骨肉瘤保肢治疗疗效分析

新辅助化疗联合保肢手术治疗四肢骨肉瘤的近远期效果王巍;张晓晶;柏合【期刊名称】《中国医药导报》【年(卷),期】2014(000)025【摘要】目的：观察并探讨新辅助化疗联合保肢手术治疗四肢骨肉瘤的近远期效果。

方法入选2007年7月~2011年2月辽宁省肿瘤医院66例四肢骨肉瘤行保肢术患者为研究对象,分为观察组(34例)与对照组(32例),观察组采用新辅助化疗+保肢手术+术后辅助化疗方案,对照组采用保肢手术+术后辅助化疗方案,对比两组化疗期间毒性反应、治疗半年后肢体功能及3年生存率。

结果治疗结束后6个月,观察组肢体功能Enneking评分[(25.7±3.1)分]高于对照组[(24.2±2.8)分],差异有统计学意义(t=2.059,P=0.044)；观察组优良率(70.6%)高于对照组(53.1%),差异无统计学意义(字2=2.136,P=0.144)。

两组化疗期间毒副作用级别以玉~域级为主,芋级少见,郁级罕见,毒副作用发生率差异无统计学意义(P跃0.05)。

化疗结束后随访36个月,观察组平均生存时间[(33.3±0.9)个月]长于对照组[(29.8±1.3)个月],差异有统计学意义(t=12.924,P<0.001)。

观察组3年生存率(73.5%)高于对照组(56.3%),差异均无统计学意义(字2=2.168,P=0.141)。

两组总体生存时间分布差异无统计学意义(字2=2.856,P=0.091)。

结论新辅助化疗联合保肢术较之单纯保肢术治疗四肢骨肉瘤至少能在不明显增加化疗毒副作用基础上,改善肢体功能,并表现出延长术后生存时间与远期生存率的趋势。

%Objective To observe and explore short and long term clinical efficacy of neoadjuvant chemotherapy com-bined with limb salvage operation in treatment of extremity osteosarcoma. Methods 66 osteosarcoma cases underwent limb salvage surgery from July2007 to February 2011 were enrolled as research objects, and divided into observation group (34 cases) and control group (32 cases), observation group was applied with neoadjuvant chemotherapy combined with limb salvage operation and postoperative adjuvant chemotherapy, control group was given limb salvage operation and postoperative adjuvant chemotherapy, toxicities of chemotherapy, limb function after treatment for 6 months and 3 year survival rate were compared between two groups. Results 6 months after the end of treatment, limb function En-neking score of the observation group [(25.7±3.1) scores] was higher than that of the control group [(24.2±2.8) scores], t he difference was statistically significant (t=2.059, P=0.044); the excellent and good rate of observation group (70.6%) was higher than that of the control group (53.1%), no statistically significant difference (χ²=2.136, P=0.144). Toxicity level of two g roups during chemotherapy focused on gradeⅠ and gradeII, grade Ⅲ was less, grade Ⅳ was rare, and toxicity rate of two groups had no significant difference (P> 0.05). After 36 months follow-up, the mean survival time of observation group [(33.3±0.9) months] was longer than control group [(29.8±1.3) months], the difference was statisti-cally significant (t=12.924, P<0.001). 3 years survival rate of observation group (73.5%) was higher than control group (56.3%), the difference was not statistically significant (χ²=2.168, P=0.141). Difference on survival time distribution of two groups had no significant difference (χ²=2.856, P=0.091). Conclusion The neoadjuvant chemotherapy combined with limb salvage surgery compared with limb salvage surgery only for osteosarcoma at least can not increasethe toxic-ities of chemotherapy, whilst improve physical function, and show the trend of prolong postoperative survival time and long-term survival rate.【总页数】5页(P39-42,57)【作者】王巍;张晓晶;柏合【作者单位】辽宁省肿瘤医院骨软外科，辽宁沈阳 110042;辽宁省肿瘤医院骨软外科，辽宁沈阳 110042;辽宁省肿瘤医院骨软外科，辽宁沈阳 110042【正文语种】中文【中图分类】R738.1【相关文献】1.新辅助化疗联合保肢手术治疗四肢骨肉瘤患者的疗效研究 [J], 高强;李晓锋2.保肢手术联合新辅助化疗治疗四肢原发性骨肉瘤疗效对照研究 [J], 邢林卿;武永娟;田明波;马利阁;张保龙;尹万乐;李达;尤笑迎3.新辅助化疗联合外科保肢手术治疗骨肉瘤远期生存分析 [J], 段宁;王金堂;张文韬4.含洛铂动脉灌注化疗联合保肢手术治疗肢体骨肉瘤的近远期临床疗效及其对Ras、ErbB3和PTEN含量的影响 [J], 卢贤哲;唐毓金5.新辅助化疗联合保肢手术治疗四肢骨肉瘤的临床研究 [J], 敖泽飞;唐际存;王梨明;甘华杨;余贵斌因版权原因，仅展示原文概要，查看原文内容请购买。

保肢治疗骨肉瘤临床分析(附11例报告)
列建就
【期刊名称】《河北医学》
【年(卷),期】2005(011)002
【摘要】目的:探讨肢体骨肉瘤保肢手术结合化疗的临床疗效.方法:对11例四肢骨肉瘤患者进行保肢治疗, 其中11例进行了术前、后新辅助化疗.按Enneking 分期, IIA期3例, IIB期8例.施行瘤段截除灭活再植术8例,人工关节置换术3例.结果:发生并发症3例, 其中皮肤坏死1例、切口感染2例.随访时间4～25月, 平均12.6月.按Enneking评分:结果为优4 例,良5例, 可2例,优良82.2%.结论: 保肢手术结合新辅助化疗是治疗肢体骨肉瘤的最好方法.
【总页数】2页(P145-146)
【作者】列建就
【作者单位】广东省增城市人民医院骨科,广东,增城,511300
【正文语种】中文
【中图分类】R738.1
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因版权原因，仅展示原文概要，查看原文内容请购买。