摘要
目的研究新辅助化疗联合保肢手术治疗四肢骨肉瘤患者的疗效。方法选取132例四肢骨肉瘤进行保肢术,根据治疗方法分为观察组和对照组。对照组64例患者采用保肢手术+术后辅助化疗方案进行治疗,观察组68例患者采用新辅助化疗+保肢手术+术后辅助化疗方案进行治疗。对比两组患者治疗半年后肢体功能、化疗期间毒性反应、3年生存率。结果两组患者化疗期间胃肠道反应、血小板减少、白细胞下降、肝功能损害、末梢神经毒性、肾功能损害发生率比较差异均无统计学意义(P>0.05)。观察组患者肢体功能Enneking评分高于对照组患者,比较两组间差异具有统计学意义(P<0.05)。观察组患者优良率高于对照组患者,两组比较差异无统计学意义(P>0.05)。化疗3年后,观察组患者的平均生存时间显著长于对照组患者,两组比较差异具有统计学意义(P<0.05)。结论较单纯保肢手术治疗四肢骨肉瘤,新辅助化疗联合保肢手术能够改善患者肢体功能,延长术后生存时间和远期生存率。
Objective To study the efficacy of neoadjuvant chemotherapy and limb salvage surgery for limb osteosarcoma. Methods 132 cases of limb osteosarcoma treated with limb salvage surgery,according to surgical methods,were divided into the observation group and the control group. The control group were treated with limb salvagesurgery plus adjuvant chemotherapy,the observation group( n = 68) were treated with neoadjuvant chemotherapy and limb salvage surgery plus adjuvant chemotherapy. Limb function 6 months after operation,toxicity during chemotherapy,and 3-year survival rate of the 2 groups were compared.Results There had no significant difference between the 2 groups during chemotherapy in gastrointestinal reactions,thrombocytopenia,leukopenia,hepatic dysfunction,peripheral neurotoxicity,and incidence of renal impairment( P > 0. 05). Limb function Enneking score in the observation group was higher than that of the control group,there had significant difference( P < 0. 05). Excellent rate in the observation group was higher than that of the control group,there had no significant difference( P > 0. 05). 3years after chemotherapy,the average survival time in the observation group was longer than that of the control group,there had significant difference( P < 0. 05). Conclusion Compared with simple limb salvage surgery,neoadjuvant chemotherapy combined with limb salvage surgery for limb osteosarcoma can improve physical function,prolong survival time and increase long-term survival rate.
出处
《实用癌症杂志》
2015年第6期821-823,827,共4页
The Practical Journal of Cancer
关键词
新辅助化疗
保肢手术
四肢骨肉瘤
Neoadjuvant chemotherapy
Limb osteosarcoma
Limb bone sarcomas
