新辅助化疗联合保肢手术对局灶性骨肉瘤患者肿瘤负荷及治疗结局的影响  

Effects of Neoadjuvant Chemotherapy Combined with Limb Salvage Surgery on Tumor Burden and Outcome of Patients with Focal Osteosarcoma

作　　者：姜宏[1] 池晓峰[1] 杨东[1] 刘洪波[1] 梁衍涛[1] JIANG Hong;CHI Xiaofeng;YANG Dong;LIU Hongbo;LIANG Yantao(Department of Bone and Soft Tissue Tumor Surgery,Jilin Cancer Hospital,Changchun,Jilin,130012,China)

机构地区：[1]吉林省肿瘤医院骨与软组织肿瘤外科

出　　处：《肿瘤药学》2019年第4期595-598,共4页Anti-Tumor Pharmacy

基　　金：辽宁省科学技术奖获奖项目（2013J-3-159）

摘　　要：目的探讨新辅助化疗联合保肢手术对局灶性骨肉瘤患者肿瘤负荷及治疗结局的影响。方法回顾性分析2013年2月-2016年5月我院收治的81例局灶性骨肉瘤患者的病历资料,分为对照组(39例,接受单纯保肢手术治疗)和观察组(42例,接受新辅助化疗联合保肢手术治疗)。对比两组患者血清肿瘤标志物骨碱性磷酸酶(BALP)、胰岛素样生长因子-1(IGF-1)、多胺(polyamine)、血清淀粉样蛋白A(SAA)和外周血调节性T细胞(Treg)分布的差异,术后随访2年,记录患者无进展生存时间(PFS)和总生存时间(OS)。结果术后1周,观察组患者血清BALP、IGF-1、polyamine、SAA水平均显著低于对照组(P<0.05),外周血Treg分布比例显著低于对照组(P<0.05)。随访2年,观察组患者的PFS和OS均长于对照组(P<0.05)。结论局灶性骨肉瘤患者在实施保肢手术前接受MMIT新辅助化疗,可进一步降低机体的肿瘤负荷,并有助于延长其PFS和OS。Objective To study the effects of neoadjuvant chemotherapy combined with limb salvage surgery on tumor burden and outcome in patients with focal osteosarcoma.Methods A retrospective analysis was made on the data of 81 cases of focal osteosarcoma patients who were treated in our hospital between February 2013 and May 2016.According to the different treatments,patients were divided into control group(n=39)and observation group(n=42).The control group underwent limb salvage surgery alone,while the observation group underwent neoadjuvant chemotherapy combined with limb salvage surgery.The serum tumor markers such as bone alkaline phosphatase(BALP),insulin-like growth factor-1(IGF-1),polyamine and serum amyloid protein A(SAA),and distribution of regulatory T cells(Treg)in peripheral blood were compared between two groups.All patients were followed up for two years.The progression-free survival time(PFS)and overall survival time(OS)were recorded and compared.Results One week after operation,the serum levels of BALP,IGF-1,polyamine and SAA in observation group were lower than in control group(P<0.05),and the percentage of Treg in peripheral blood was lower than that of control group(P<0.05).During follow-up period,the PFS and OS of the observation group were longer than those of control group(P<0.05).Conclusion MMIT neoadjuvant chemotherapy before limb salvage surgery in patients with focal osteosarcoma can further reduce tumor burden and help to prolong PFS and OS after treatment.

关 键 词：局灶性骨肉瘤 新辅助化疗 保肢手术 肿瘤负荷 治疗结局 

分 类 号：R738.1[医药卫生—肿瘤]