新辅助化疗联合保肢手术治疗四肢骨肉瘤的临床研究  

Neoadjuvant chemotherapy combined with limb salvage surgery for the treatment of limb osteosarcoma

作　　者：敖泽飞 唐际存[1] 王梨明[1] 甘华杨 余贵斌 AO Zefei;TANG Jicun;WANG Liming;GAN Huayang;YU Guibin(Department of Humeral Hand Surgery, Affiliated Hospital of Guilin Medical College, Guilin 541001, China)

机构地区：[1]桂林医学院附属医院四肢创伤手外科,桂林541001

出　　处：《广州医药》2018年第6期75-78,共4页Guangzhou Medical Journal

基　　金：广西自然科学基金(02030140381)

摘　　要：目的研究新辅助化疗联合保肢手术治疗骨肉瘤的临床效果。方法根据既往治疗骨肉瘤方法的不同,将56例患者分为对传统保肢组(A组)和现代保肢组(B组),各28例。A组用采用传统保肢方案,即保肢手术+术后化疗方案进行;B组采用现代保肢方案,即新辅助化疗+保肢手术+术后化疗方案进行。化疗方案均采用CTX+VCR+MTX+ADM方案,比较两组转移/复发率、术后1年、2年及3年生存率、肢体功能、临床疗效情况。结果比较两组的转移/复发率及3年后的死亡率,B组低于A组(P<0.05);肢体功能优良率及临床疗效,B组高于A组(P<0.05)。结论新辅助化疗联合保肢手术能够降低骨肉瘤患者转移/复发率、死亡率,改善肢体功能,提高临床疗效。Objective To study the clinical effect of neoadjuvant chemotherapy combined with limb salvage surgery for osteosarcoma.Methods Based on the previous methods of treating osteosarcoma,56patients were divided into the traditional limb salvage group(A group)and the modern limb salvage group(B group),28cases for each.The traditional limb salvage surgery+postoperative chemotherapy regimen were used in group A,and modern limb salvage regimen was performed in group B,ie neoadjuvant chemotherapy+limb salvage surgery+postoperative chemotherapy.The CTX+VCR+MTX+ADM protocol was used in the chemotherapy regimens.The metastasis/recurrence rate,the1-year,2-year and3-year survival rates,limb function,and clinical efficacy were compared between the two groups.Results The metastasis/recurrence rate and the mortality rate after3years in the two groups were compared.The B group was lower than that of the group A(P<0.05).The excellent rate of limb function and clinical efficacy were higher in the B group than that of in the group A(P<0.05).Conclusion Neoadjuvant chemotherapy combined with limb salvage surgery may reduce the metastasis/recurrence rate and mortality of osteosarcoma patients,improve limb function and increase clinical efficacy.

关 键 词：骨肉瘤 保肢手术、新辅助化疗 

分 类 号：R738.1[医药卫生—肿瘤]