新辅助化疗与保肢手术治疗骨肉瘤患者的临床效果及对肢体功能、复发率的影响

Clinical Effects of Neoadjuvant Chemotherapy and Limb-preserving Surgery in Treating Patients with Osteosarcoma and Their Impact on Limb Function and Recurrence Rate

目的探讨新辅助化疗与保肢手术治疗骨肉瘤(osteosarcoma,OS)患者的临床效果及对肢体功能和复发率的影响。方法方便选取2020年1月—2021年8月山西省肿瘤医院收治的63例骨肉瘤患者为研究对象,采用随机数表法分为参照组(32例)和观察组(31例)。参照组给予保肢手术治疗,观察组给予新辅助化疗与保肢手术联合治疗,比较两组患者的临床总有效率、肿瘤标志物水平、肢体功能及预后情况。结果观察组临床总有效率为77.42%高于参照组的53.13%,差异有统计学意义(χ^(2)=4.089,P<0.05)。治疗后,观察组肿瘤特异性生长因子(tumor specific growth factor,TSGF)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、血清淀粉样蛋白A(serum amyloid A,SAA)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)水平均低于参照组,差异有统计学意义(P<0.05)。治疗后,观察组肢体功能评分高于参照组,差异有统计学意义(P<0.05)。观察组随访两年生存率高于参照组,局部复发或者转移率低于参照组,差异有统计学意义(P<0.05)。结论骨肉瘤患者给予新辅助化疗联合保肢手术治疗,有效率提高,且可抑制肿瘤细胞增长,改善肢体功能,提升生存率,有效控制骨肉瘤患者局部或者转移复发率。

Objective Explore the clinical efficacy of neoadjuvant chemotherapy and limb salvage surgery in the treatment of osteosarcoma(OS)patients,as well as their impact on limb function and recurrence rate.Methods 63 patients with osteosarcoma admitted to Shanxi Cancer Hospital from January 2020 to August 2021 were conveniently selected as the research subjects.They were randomly divided into a reference group(32 cases)and an observation group(31 cases)using a random number table method.The reference group was treated with limb salvage surgery,while the observation group was treated with a combination of neoadjuvant chemotherapy and limb salvage surgery.The clinical total response rate,tumor marker levels,limb function,and prognosis of the two groups of patients were compared.Results The total clinical effective rate of 77.42%in the observation group was higher than 53.13%in the reference group,the difference was statistically significant(χ^(2)=4.089,P<0.05).After treatment,the levels of tumor specific growth factor(TSGF),vascular endothelial growth factor(VEGF),serum amyloid A(SAA),bone alkaline phosphatase(BALP)SAA in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).After treatment,the limb function score of the observation group was higher than that of the reference group,the difference was statistically significant(P<0.05).The 2-year follow-up survival rate of the observation group was higher than that of the reference group,and the local recurrence or metastasis rate was lower than that of the reference group,the difference was statistically significant(P<0.05).Conclusion Osteosarcoma patients given neoadjuvant chemotherapy combined with limb-preserving surgery treatment,the effective rate is increased,and can inhibit the growth of tumor cells,improve limb function,enhance the survival rate,and effectively control the local or metastatic recurrence rate of osteosarcoma patients.