老年骨肉瘤患者的临床特征与预后  

Clinical features and prognosis of osteosarcoma in elderly patients

作　　者：王倩荣[1] 吴晋[1] 刘文超[1] 王臻[2] 张红梅[1] 

机构地区：[1]第四军医大学西京医院肿瘤科,西安710032 [2]第四军医大学西京医院骨肿瘤科,西安710032

出　　处：《中国骨与关节杂志》2017年第2期92-95,共4页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金面上项目(81572699);陕西省科学技术研究发展计划项目(2013KJXX-91)

摘　　要：目的探讨老年骨肉瘤患者的临床特点及预后。方法收集2010至2013年我院收治的30例老年人(≥60岁)骨肉瘤病例进行回顾性分析,运用SPSS 13.0软件进行统计学分析,预后因素采用χ~2检验;根据相关随访资料统计生存率。结果 30例中,男19例,女11例,年龄60~86岁,平均70岁。28例平均随访25个月,2例失访,随访率为93.3%。28例获随访者均经手术治疗,其中单纯手术治疗13例,术后辅助放疗6例,术后辅助放化疗9例。28例获随访者中,1年生存率约67.8%;3年生存率为35.7%。单纯手术切除组与手术联合放化疗组,生存差异有统计学意义(P<0.01)。血清碱性磷酸酶(AKP)升高者较正常者预后差,差异有统计学意义(P<0.05)。结论对于老年性骨肉瘤患者手术联合放化疗对改善预后有益。AKP可作为预测患者预后的指标之一。Objective To investigate the clinical features and prognosis of osteosarcoma in elderly patients. Methods The 30 elderly cases of osteosarcoma （ over 60 years old ） collected in our hospital from 2010 to 2013 were analyzed retrospectively. SPSS 13.0 software was applied for statistical analysis and the χ2 test was performed for prognostic factors. The survival rate was calculated according to the follow-up information. Results There were 19 males and 11 females, with a mean age of 70 years old （ range： 60 - 86 years ）. Among the 30 cases, 28 cases were followed up for an average period of 25 months and the follow-up rate was 93.3%, with 2 cases of loss of follow-up. All the 28 cases received operation therapy, among whom only surgical treatment was performed in 13 cases, postoperative adjuvant radiotherapy in 6 cases, and postoperative adjuvant radiotherapy and chemotherapy in 9 cases. The average one-year and 3-year survival rates of all the 28 targeted patients were about 67.8% and 35.7%, respectively. There were statistically significant differences in survival between the sole surgical resection group and postoperative adjuvant radiotherapy and chemotherapy group （ P 〈 0.01 ）. The patients with elevated alkline phosphatase （ AKP ） had poorer prognosis than normal subjects, with statistically significant differences （ P 〈 0.05 ）. Conclusions Surgery combined with radiotherapy and chemotherapy can help to improve the prognosis of elderly patients with osteosarcoma. AKP can be used as one of effective indicators to predict the prognosis of the patients with osteosarcoma.

关 键 词：骨肉瘤 老年人 术后辅助放疗 术后辅助化疗 外科手术 预后 

分 类 号：R738.1[医药卫生—肿瘤]