体外循环热药灌注术治疗下肢肌骨系统恶性肿瘤的效果  

Extracorporeal circulation and hyperthermal perfusion of cisplatin for musculoskeletal malignant tumors

作　　者：史福东[1] 李长江[1] 宋金刚[2] 

机构地区：[1]唐山市肿瘤医院骨软组织肿瘤科,063001 [2]天津市肿瘤医院骨软组织肿瘤科

出　　处：《中国骨肿瘤骨病》2008年第4期217-220,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨体外循环热药灌注治疗肌骨系统恶性肿瘤。方法对20例下肢恶性肿瘤行股动、静脉插管,体外循环,顺铂加热灌注化疗1h。软组织肉瘤灌注术前行新辅助化疗,术后行广泛切除术,再行放疗;骨恶性肿瘤灌注术前行新辅助化疗,术后行间室外切除术,而后继续术后化疗。结果11例随访2～8年,无复发及转移,肢体功能良好。5例于术后3个月～1年死亡。1例1年、2.5年复发2次,进一步治疗后5年无复发及转移。2例1～3年内局部复发,再次行广泛切除术,术后放化疗,术后无瘤生存。1例行广泛切除术后伤口皮瓣坏死、发生病理性骨折而行截肢,截肢后未行放化疗,术后5年无瘤生存。结论体外循环热药灌注术是保肢治疗肢体恶性肿瘤的方法之一。Objective To evaluate the clinical result of extracorporeal circulation and hyperthermia perfusion of cisplatin for musculoskeletal malignant tumors. Methods Twenty patients with malignant tumor in the lower extremities underwent femoral arterial and venous cannulation, extracorporeal circulation and hyperthermal perfusion of cisplatin for an hour. Neoadjuvant chemotherapy was performed before the perfusion for soft tissue sarcoma while extensive resection of tumor was performed after it. Results In the followed-up duration of 2 to 8 years, Eleven patients were alive without recurrence or metastasis. Five patients died of lung metastasis in 3 to 12 months after ILP. Recurrence was detected in l patient in l year and 2.5 years after ILP respectively. With further treatment, no recurrence or metastasis was found at the follow-up 5 years later. Two patients sustained local recurrence in 2 to 3 years postoperatively, They underwent extensive resection again and postoperative adjuvant chemotherapy. No recurrence was found at follow-up. Conclusions Extremity-salvaging surgery with the hyperthermia perfusion of cisplatin is an effective option to treat malignant tumors in extremities.

关 键 词：四肢恶性肿瘤 顺铂 加温灌注 保肢治疗 

分 类 号：R738[医药卫生—肿瘤]