含吡柔比星方案治疗骨肉瘤肺转移患者的疗效及心脏功能评估  

The effect of pirarubicin chemotherapeutic regimen on osteosarcoma associated with lung metastasis and myocardial function assessment

作　　者：赵晖[1] 杨晨[1] 王智煜[1] 姚阳[1] 

机构地区：[1]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《肿瘤》2010年第10期860-864,共5页Tumor

基　　金：上海市科学技术委员会科研计划项目(编号:08411960500)

摘　　要：目的:本研究旨在探讨含吡柔比星(pirarubicin, THP)方案治疗骨肉瘤肺转移患者的疗效,并对心脏功能等相关不良反应进行评估.方法:32例骨肉瘤肺转移患者接受THP (50 mg/m2, d 1)联合顺铂(cisplatin, DDP)(80 mg/m2,分成2～3 d)或异环磷酰胺(ifosfamide, IFO)(8 g/m2,分成4 d)治疗,评价近期疗效.应用心脏超声检测患者THP治疗前后左室射血分数和E/A值等心脏功能指标.结果: 含THP方案治疗骨肉瘤肺转移患者中位总生存时间为(31.00±7.98)个月,无疾病进展时间为(13.00±2.46)个月,客观缓解率为46.88%,部分缓解率为40.63%.含THP方案化疗的不良反应主要为胃肠反应和骨髓抑制;THP不同累积剂量组左室射血分数差异无统计学意义,THP累积剂量较大组的E/A值较化疗前明显降低(P＜0.05).结论:含THP方案治疗骨肉瘤肺转移患者是较为有效和安全的,可以作为挽救性化疗选择方案.二维彩色多普勒超声技术可作为评价蒽环类药物早期心脏毒性的检测手段之一.Objective:To evaluate the clinical effect of pirarubicin(THP) chemotherapeutic regimen on osteosarcoma with lung metastasis,detect the heart function,and evaluate the adverse reactions induced by THP.Methods:For the 32 patients THP 50 mg/m2 was given on day 1 and cisplatin(DDP) was given for 2-3 d with total dosage of 80 mg/m2 or ifosfamide(IFO) was given for 4 d with total dosage of 8 g/m2.A color Doppler ultrasound echocardiography was used to measure the ejection ratio of left ventricle and the heart function parameters such as E/A value.Results:The survival time was(31.00±7.98)months and the disease free time was(13.00±2.46)months.The objective remission rate was 46.88% and the partial remission rate was 40.63% in osteosarcoma patients with lung metastasis after combined THP chemotherapy.The side effects induced by THP treatment mainly involved gastrointestinal reaction and bone marrow depression.The left ventricular ejection fraction showed no significant difference between the groups who received various THP cumulative dosages.The E/A value was significantly decreased in high THP cumulative dosage group after chemotherapy(P0.05).Conclusion:The THP chemotherapeutic regimen is effective and safe in the treatment of osteosarcoma with lung metastasis,which could be served as a salvage chemotherapeutic regimen.Two dimensional and color Doppler echocardiography may be valuable to assess the early cardiotoxicity induced by anthracyclines.

关 键 词：吡柔比星 选择方案 治疗 骨肉瘤 肺转移 患者 近期疗效 心脏功能指标 功能评估 myocardial function lung metastasis 左室射血分数 THP 累积剂量 不良反应 多普勒超声技术 心脏超声检测 疾病进展时间 缓解率 化疗 

分 类 号：R73[医药卫生—肿瘤]