广泛切除术联合术中^(125)I粒子植入治疗肢体软组织肉瘤的临床疗效分析  

The analysis of clinical effect of limbs soft tissue sarcoma with the treatment of wide excision combined with intraoperative ^(125)I seed implantation

作　　者：牛宁奎[1] 施建党[1] 丁惠强[1] 王学伟[1] 杨宗强[1] 师志云[1] 王自立[1] 

机构地区：[1]宁夏医科大学总医院脊柱外科,银川750004

出　　处：《骨科》2015年第6期302-305,309,共5页ORTHOPAEDICS

基　　金：2011年度宁夏自然科学基金资助项目(NZ11195;NZ11275)

摘　　要：目的探讨广泛切除术联合术中125I粒子植入治疗肢体软组织肉瘤的临床疗效。方法回顾性分析2010年5月至2012年8月采用广泛切除术治疗的肢体软组织肉瘤患者40例,均采用广泛切除术,根据治疗方式不同将患者分为:术中仅行125I粒子植入的患者20例(粒子组),术后仅行体外放疗的患者20例(放疗组)。比较两组肿瘤治愈率、复发率;患者对术中125I粒子植入与术后放疗的依从性和满意程度;术后并发症。结果全部病例获得随访,随访时间为2.5~5.0年,平均3.5年。粒子组中19例肿瘤治愈,1例术后复发;19例患者对该治疗方法满意。放疗组中16例肿瘤治愈,4例术后复发;12例对术后放疗的治疗方法满意。两组肿瘤治愈率、复发率差异均无统计学意义(均P>0.05),但粒子组的依从性、满意度明显高于放疗组,差异均有统计学意义。两组皮肤纤维化、水肿出现比率差异有统计学意义,而其他并发症差异无统计学意义。结论广泛切除术联合术中125I粒子植入治疗肢体软组织肉瘤疗效显著,安全性高,并发症少,且患者易于接受。Objective To analysis of clinical efficacy on soft tissue sarcoma （STS） by the treat- ment of wide excision of lesions combined with intra-operative iodine 125I） seeds implantation. Methods Retrospective analysis of 40 patients with STS who had been treated with wide excision of lesions from May 2010 to Aug. 2012. The patients were divided into 2 groups., group Seeds （20 patients） scheduled for intra-operative 125I seeds implantation, and group Radio （20 patients） scheduled for postoperative radiotherapy. We observed and compared cure rate, recurrence rate of tumor, patient compliance and satisfaction, and postoperative complications between the groups. Results All patients were followed post operation for 2. 5 to 5.0 years （average of 3. 5 years）. Group Seeds： 19 cases were cured; 1 case recurrence; 19 cases were satisfied with the treatment of intra-operative implantation of 125I seeds. Group Radio： 16 cases were cured; 4 cases recurrence; 12 cases were satisfied with postoperative radiotherapy treatment. There was no significant difference in the cure rate and recurrence rate between groups Seeds and Radio. Group Seeds was significantly higher in the compliance and satisfaction than group Radio. There were significant difference in the skin fibrosis and edema ratio between group Seeds and Radio, whereas no significant difference in other complications. Conclusion After STS were treated with wide excision, using intra-operative 125I seeds implantation were effective, safe, with fewer complications, and easily accepted by patients.

关 键 词：外科手术 碘放射性同位素 软组织肿瘤 疗效比较研究 放化疗 辅助 

分 类 号：R738.6[医药卫生—肿瘤]