新辅助化疗联合保肢手术治疗骨肉瘤的临床研究  

Clinical study of neoadjuvant chemotherapy combined with limb salvage surgery for osteosarcoma

作　　者：翟墨[1] 

机构地区：[1]辽宁省人民医院骨肿瘤科,辽宁沈阳110000

出　　处：《中国现代医生》2016年第1期58-61,共4页China Modern Doctor

摘　　要：目的探讨新辅助化疗联合保肢手术治疗骨肉瘤的临床疗效。方法将60例骨肉瘤患者根据治疗方法的不同分为观察组和对照组,各30例。对照组采用肿瘤根治术或肿瘤广泛切除术,术后行常规化疗3~4疗程。观察组采用新辅助化疗联合保肢手术,术后常规化疗3~4疗程,化疗方案均采用ADM＋DDP＋MTX＋IFO方案。比较两组转移/复发情况、术后1年、2年及3年生存率。比较两组肢体功能及生活质量。结果随访时间为8~37个月,平均（27.4±7.5）个月。术后3年,观察组术后3年生存率为80.0%,显著高于对照组（χ~2=4.800,P〈0.05）。观察组术后复发/转移率为16.7%,显著低于对照组（χ~2=5.079,P〈0.05）。观察组优良率63.3%,显著高于对照组的36.7%（χ~2=4.267,P〈0.05）。观察组肢体功能评分（23.9±6.5）分,显著高于对照组的（15.3±4.8）（t=5.829,P〈0.05）。观察组社会功能、躯体功能、精神状态及总体健康评分均显著高于对照组（t=2.459、3.146、2.419、2.325,P〈0.05）。结论新辅助化疗联合保肢手术治疗骨肉瘤能够提高患者治疗效果,改善肢体功能及生活质量。Objective To investigate the clinical effect of neoadjuvant chemotherapy combined with limb salvage surgery in the treatment of osteosarcoma. Methods A total of 60 patients with osteosarcoma were divided into observation group and control group according to different treatment methods,30 cases in each group. The control group were treated with tumor radical resection or tumor resection,3-4 treatment of routine chemotherapy after operation. The observation group was treated with new adjuvant chemotherapy combined with limb salvage surgery,3-4 treatment of routine chemotherapy, DDP＋MTX＋IFO＋ADM regimen was used in the chemotherapy program. The the survival rate of 1 years,2 years, 3 years after surgery, the function and quality of life of the two groups were compared. Results The follow-up time was 8-37 months, average（27.4±7.5） months. 3 years after operation, the survival rate of the observation group was80% after 3 years, significantly higher than the control group（χ~2=4.800,P〈0.05）. The recurrence/metastasis rate of the observation group was 16.7%, significantly lower than the control group（χ~2=5.079,P〈0.05）. The curative effect of the observation group was 63.3%, significantly higher than those in the control group（χ~2=4.267,P〈0.05）. The body function score of the observation group（23.9±6.5） was significantly higher than the control group（15.3±4.8）（t=5.829,P〈0.05）. The social function, physical function, mental status and overall health scores of the observation group were significantly higher than those in the control group（t=2.459,3.146,2.419,2.325,P〈0.05）. Conclusion Neoadjuvant chemotherapy combined with limb salvage surgery can improve the treatment effect of patients with osteosarcoma, Improve physical function and quality of life.

关 键 词：骨肉瘤 新辅助化疗 保肢手术 肢体功能 

分 类 号：R738.1[医药卫生—肿瘤]