肌骨系统恶性肿瘤的保肢治疗(附102例报告)  

Limb-salvage Surgery for Malignant Tumors in Extremities:a Report of 102 Cases

作　　者：李长江[1] 史福东[2] 宋金刚[3] 

机构地区：[1]唐山市肿瘤医院骨软组织肿瘤科,河北省唐山市063000 [2]河北省唐山市人民医院骨科 [3]天津市肿瘤医院骨软组织肿瘤科,河北省唐山市063000

出　　处：《中国肿瘤临床》2008年第12期676-679,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨肌骨系统恶性肿瘤的保肢治疗。方法:对1999年3月～2007年9月102例骨及软组织恶性肿瘤几种保肢治疗措施及愈后情况进行分析、总结。结果:102例病例中有76例进行了4～6轮较完整新辅助化疗,有26例未做化疗或只做了简单的术后化疗;其中76例新辅助化疗患者有12例在4年内无复发及转移,有10例5年内无复发及转移,41例6年无复发及转移;102例病例中有40例行广泛切除术,19例行间室切除术,4例行扩大广泛切除术,39例行边缘切除。其中40例行广泛切除术的患者有13例5年内无复发,9例6年内无复发,3例8年内无复发,功能良好;19例行间室切除术的患者有11例术后随访2～8年未见复发及转移;4例行扩大广泛切除术(根治性切除)患者中有3例随访1～5年未见复发及转移。结论:肌骨系统恶性肿瘤的保肢治疗应按分期,生物学特性,对化疗的敏感性等采取新辅助化疗、广泛切除术、间室切除术、扩大广泛切除术(根治性切除)、体外循环热药灌注术、瘤段骨煮沸灭活再植术、人工假体置换术等综合治疗。首次手术是关键,化疗是基石。Objective： To study the effect of limb-salvage surgery for malignant tumors in limbs. Methods： Data from 102 patients with malignant limb tumors treated between March 1999 and September 2007 were reviewed and analyzed. Results： Seventy-six patients were treated with 4-6 cycles of neoadjuvant chemotherapy, and the other 26 cases received no chemotherapy or were treated with postoperative chemotherapy alone. Of the 76 patients treated with neoadjuvant chemotherapy, 12 cases did not relapse in four years, 10 cases did not relapse in five years, and 41 cases did not relapse in six years. Of all 102 cases, 40 were treated with radical excision, of which 13 cases did not relapse in five years, 9 cases did not relapse in six years, and 3 cases did not relapse in eight years. Conclusion： Malignant tumors in limbs should be treated with combination therapy based on stage, classification, biological characteristics, and sensitivity to chemotherapy. Surgery and chemotherapy together are essential for achieving a satisfactory survival rate.

关 键 词：肌骨系统恶性肿瘤 保肢治疗 新辅助化疗 

分 类 号：R738[医药卫生—肿瘤]