人工关节置换联合新辅助化疗治疗膝关节周围骨肉瘤  

Application of Chemotherapy Combined with Join Replacement in the Treatment of Osteosarcoma a- round Knee

作　　者：高明堂[1] 蒋电明[2] 刘军[1] 鲁培[3] 符孔龙[1] 张陆[1] 高松明 

机构地区：[1]河南省郑州人民医院骨科,450053 [2]重庆医科大学附属第一医院骨科 [3]郑州大学附属第一医院肿瘤科

出　　处：《解剖与临床》2011年第4期289-291,共3页Anatomy and Clinics

摘　　要：目的：探讨新辅助化疗联合人工关节置换应用于膝关节周围骨肉瘤保肢治疗的可行性.方法：自2002年9月～2009年10月,对病理活检确诊的38例膝关节周围骨肉瘤患者,采用Rosen T19方案化疗2个疗程后行人工关节置换术,术后化疗4～6个疗程.其中,按Enneking分期为IA期2例,IB期3例,IIA期23例,IIB期10例.结果：38例中,37例获随访,随访时间18～42个月,平均28个月,随访期间所有患者均成活,无假体松动和折断.膝关节按ISOLS关节功能评定标准,优24例,良6例,差7例,本组患膝关节功能优良率为83.8%.结论：对于早期骨肉瘤,新辅助化疗联合人工关节置换术是膝关节周围骨肉瘤保肢治疗的有效措施.Objective： To discuss the chemotherapy combined with customized total knee replacement and the feasibility in the limb salvage treatment of osteosarcoma around knee. Methods：38 patients （18 -42 years old） with osteosarcoma around knee were selected from Sep. 2002 to Oct. 2009, 24 cases of male; 4 ca- ses of female. 30 cases in distal femoral, 8 cases in proximal tibia. 37 cases of osteosarcoma around knee were retrospectively analyzed by general treatment of the three stages： 37 cases under went 2 cycles ofpreoperative chemotherapy, operative resection of the tumor and the replacement and 4 -6 cycles of posloperative chemotherapy. Results：Except for one lost, All the eases underwent 18 -42 months follow -up （average of 28 months）. The limb function was evaluated by ISO1,S standard,there was 24 eases excellent,6 cases good and 7 cases bad. The excellent and good rate of the limb function were 83.8% , without prosthetic loosening and broking. All the patients were alive. Conclusions：It is an effective measure to treat osteosarcoma around knee with customizcd total knee prosthesis replacement with lower loeal recurrence and good knee function.

关 键 词：化疗 关节置换术 骨肉瘤 保肢 

分 类 号：R738.1[医药卫生—肿瘤] R687.4[医药卫生—临床医学]