含洛铂方案的新辅助化疗在骨肉瘤及尤因肉瘤中的疗效观察  

Observation on the curative effects of the lobaplatin scheme contained neoadjuvant chemotherapy in treating the osteosarcoma and Ewing sarcoma

作　　者：朱皓东[1] 吴智钢[1] 王臻[1] 郭征[1] 石磊[1] 高明暄[1] 

机构地区：[1]第四军医大学西京医院骨肿瘤科,西安710032

出　　处：《中国骨与关节外科》2013年第3期225-229,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:化疗是骨肉瘤及尤因肉瘤最主要的治疗手段之一,目前化疗疗效已进入平台期,选择低毒高效的化疗药物及方案是关键。目的:观察含洛铂(LBP)方案的新辅助化疗对骨肉瘤及尤因肉瘤的疗效及不良反应。方法:2011年10月至2012年10月收治经病理学检查确诊为原发恶性骨肿瘤患者22例,其中骨肉瘤13例,尤因肉瘤9例;男17例,女5例,年龄9～23岁,平均18.3岁;Enneking分期:ⅡA期3例,ⅡB期19例。给予LBP-多柔比星(AMD)方案交替异环磷酰胺(IFO)方案(LBP 30mg/m2,AMD 60mg/m2;IFO12g/m2;全身静脉给药)的新辅助化疗,后行保肢手术治疗。采用RECIST评价标准评价其疗效,并观察不良反应。结果:22例中完全缓解(CR)1例,部分缓解(PR)18例,疾病稳定(SD)3例,总有效率(RR)为86.4%。随访3～14个月,平均9.2个月,1例脊柱骨肉瘤患者术后5个月复发,其余患者未发现复发或转移征象。主要不良反应为限制性骨髓抑制,化疗间歇期患者恢复快,无明显肾功能异常及过敏反应。结论:骨肉瘤及尤因肉瘤接受含LBP方案的新辅助化疗的近期疗效满意,不良反应可耐受,值得进一步临床研究。Background：Chemotherapy is one of the main methods for treating the osteosarcoma and Ewing sarcoma.At present,the efficacy of chemotherapy has entered the platform stage,selecting chemotherapy drugs and therapeutic schemes with low toxicity and high efficiency become the key.Objective：To observe the efficacy and adverse reactions of the lobaplatin scheme contained neoadjuvant chemotherapy in treating the osteosarcoma and Ewing sarcoma.Methods：From 2011 October to 2012 October,22 patients were pathologically diagnosed with primary malignant bone tumor,including 13 cases of osteosarcoma and 9 cases of Ewing sarcoma;these 17 males and 5 females had an mean age of 18.3 years old（aged from 9 to 23 years）.According to Enneking staging system,there were 3 cases in IIA stage and 19 cases in IIB stage.All patients received the neoadjuvant chemotherapy of LBP-AMD（lobaplatin-doxorubicin） and the IFO（ifosfamide） scheme（lobaplatin 30 mg/m2,doxorubicin 60 mg/m2;ifosfamide 12 g/m2;intravenous administration） alternative therapy before the limb salvage surgery.The results were evaluated by RECIST（response evaluation criteria in solid tumors） and the adverse reactions were recorded.Results：Of the 22 cases,1 case achieved complete remission（CR）,18 cases achieved partial remission（PR）,and 3 cases got stable disease（SD）,the total response rate（RR） was 86.4%.All patients were followed up for a mean period of 9.2 months（3 to 14 months）.1 patients with spinal osteosarcoma relapsed 5 months later after the operation,while others were found with no symptom of recurrence or metastasis.The main adverse reaction was restrictive myelosuppression,but it was recovered soon during the chemotherapy diapause;there was no significant abnormal renal function and allergic reactions.Conclusions：Satisfactory short-term curative effects can be achieved in treating the osteosarcoma and Ewing sarcoma with lobaplatin scheme contained neoadjuvant chemotherapy.Its adverse reactions were acceptable,and thus d

关 键 词：洛铂 骨肉瘤 尤因肉瘤 新辅助化疗 

分 类 号：R738.1[医药卫生—肿瘤]