扁骨和不规则骨骨肉瘤预后因素分析  

Analysis of prognostic factors for osteosarcoma of the flat bone and irregular bone

作　　者：田聪[1,2] 姚阳[2] 林峰[2] 汤丽娜[2] 李洪涛[2] 祁伟祥[2] 乔光磊[2] 

机构地区：[1]苏州大学医学部,215131 [2]上海交通大学附属第六人民医院肿瘤科,200233

出　　处：《国际骨科学杂志》2013年第5期371-374,共4页International Journal of Orthopaedics

基　　金：国家自然科学基金(81102038)

摘　　要：目的 分析扁骨和不规则骨骨肉瘤患者临床特点,探讨影响预后的相关因素.方法 回顾性分析2002年2月至2010年3月收治的36例扁骨和不规则骨骨肉瘤患者的临床资料,即性别、年龄、Karnofsky体能状况（KPS）评分、新辅助化疗、辅助化疗次数、局部复发、Enneking外科分期、肺转移、手术方式、局部放疗等10项变量指标.采用Kaplan-Meier法计算生存率,Log-rank检验作单因素分析,Cox回归模型作多因素分析.结果 所有36例患者均得到4～70个月随访,中位生存时间26个月（95％可信区间10.9～41.1个月）,2年总体生存率为58.3％.单因素分析显示,KPS评分（≥90与＜90）、辅助化疗次数（≥6次与＜6次）、Enneking外科分期、肺转移、手术方式和局部放疗是扁骨和不规则骨骨肉瘤患者的预后因素（P＜0.05）；多因素分析显示,手术方式（P=0.000）和局部放疗（P=0.000）是影响患者预后的独立相关因素.结论 手术方式和局部放疗是影响扁骨和不规则骨骨肉瘤患者预后的独立因素.Objective To analysis of the clinical features of the flat bone and irregular bone osteosarcoma and the prognostic factors for survival.Methods The clinical data of 36 patients with osteosarcoma of flat bone and irregular bone between February 2002 and March 2010 were retrospectively reviewed.The factors of gender,age,Karnofsky performance-status （KPS） score,neoadjuvant chemotherapy,frequency of adjuvant chemotherapy,local recurrence,Enneking surgical staging,lung metastasis,surgical method and local radiotherapy were taken as variables.Kaplan-Meier method was used to calculate the overall survival rate,the Log-rank univariate analysis was used to determine the prognostic factors related with survival rate,and the Cox model multivariate analysis was used to identify independent prognostic factors.Results All the patients were obtained from 4 to 70months follow up.The median survival time of 36 patients was 26 months （95％ confidence interval：10.9-41.1）,two-year survival rates was 58.3％.The univariate analysis revealed that KPS score,cycles of adjuvant chemotherapy,Enneking surgical staging,lung metastasis,surgical method and local radiotherapy were associated with the prognosis of flat bone and irregular bone osteosarcoma （P＜0.05）.Cox model multivariate analysis suggested surgical method （P =0.000） and local radiotherapy （P =0.000） were the independent prognostic factors of osteosarcoma of flat bone and irregular bone.Conclusion Surgical method and local radiotherapy were the independent prognostic factors of osteosarcoma of fiat bone and irregular bone.

关 键 词：骨肉瘤 扁骨 不规则骨 预后因素 生存 

分 类 号：R738.1[医药卫生—肿瘤]