儿童四肢骨肉瘤保肢治疗临床疗效分析  

Clinical efficacy analysis of limb salvage treatment for children with extremity osteosarcoma

作　　者：杜俊炜 张强 武峻申 杨文鹏 江仁兵[1] Du Junwei;Zhang Qiang;Wu Junshen;Yang Wenpeng;Jiang Renbing(Department of Bone and Soft Tissue Tumors and Melanoma,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi Xinjiang,830000,China)

机构地区：[1]新疆医科大学附属肿瘤医院骨与软组织肿瘤及黑色素瘤科,新疆乌鲁木齐830000

出　　处：《生物骨科材料与临床研究》2023年第5期24-28,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨儿童四肢骨肉瘤保肢治疗临床疗效情况。方法回顾性分析2010年1月至2021年10月新疆医科大学附属肿瘤医院儿童四肢骨肉瘤保肢患者的临床资料。随访时间6~116个月,平均随访时间为(30.0±27.5)个月,中位生存时间为47个月。根据随访结果,分析儿童四肢骨肉瘤的发生部位、术前碱性磷酸酶、Enneking分期、手术方式、肿瘤最大直径、病理类型、是否规律完成化疗、是否局部复发以及术后肺转移情况等因素对患者预后的影响。采用单因素及多因素分析影响儿童四肢骨肉瘤保肢预后的因素。结果男女比例为1.2∶1,1年内总生存率为82.7%,3年内总生存率为53.6%,5年内总生存率为40.5%。经分析显示肿瘤最大直径≥10 cm、是否规律完成化疗、肿瘤坏死率及肺转移情况是影响儿童四肢骨肉瘤保肢患者预后的独立危险因素(P<0.05)。结论肿瘤最大直径、是否规律完成化疗、肿瘤坏死率及肺转移情况可明确影响儿童四肢骨肉瘤保肢患者预后,因此早发现、早治疗以及全程规律地完成化疗并预防肺转移的发生是治疗骨肉瘤的关键。Objective To investigate the clinical curative effect of limb salvage treatment for children with extremity osteosarcoma.Methods The clinical data of children with limb osteosarcoma in Affiliated Tumor Hospital of Xinjiang Medical University from January 2010 to October 2021 were analyzed retrospectively.The follow-up period was 6-116 months,the average follow-up time was(30.0±27.5)months,and the median survival time was 47 months.According to the follow-up results,the effects of the location of osteosarcoma in children's extremities,preoperative alkaline phosphatase,Enneking stage,surgical methods,the maximum diameter of tumor,pathological type,regular completion of chemotherapy,local recurrence,and postoperative lung metastasis on the prognosis of children were analyzed.Univariate and multivariate analyses were used to analyze the factors affecting the prognosis of limb salvage osteosarcoma in children.Results The ratio of males to females was 1.2∶1.The overall survival rate within 1 year was 82.7%.The overall survival rate within 3 years was 53.6%.The overall survival rate within 5 years was 40.5%.The analysis showed that the maximum diameter of tumor≥10 cm,regular completion of chemotherapy,tumor necrosis rate,and lung metastasis were independent risk factors affecting the prognosis of children with limb salvage osteosarcoma(P<0.05).Conclusion The maximum diameter of tumor,regular completion of chemotherapy,tumor necrosis rate and lung metastasis can clearly affect the prognosis of children with limb osteosarcoma.Therefore,early detection and early treatment and regular completion of chemotherapy and prevention of lung metastasis are the key to the treatment of osteosarcoma.

关 键 词：骨肉瘤 儿童 保肢 预后 

分 类 号：R738.1[医药卫生—肿瘤]