介入化疗与保肢手术治疗软组织肉瘤

Intra-arterial chemotherapy and limb-salvage in patients with soft tissue sarcoma

目的 研究术前动脉介入化疗与手术治疗肢体软组织肉瘤。方法 2 1例肢体软组织肉瘤 ,其中 1 3例 ( 62 %)术前影像学显示肿瘤邻近大血管或骨骼侵犯 ,采用股动脉及肱动脉插管 ,化疗 2～ 3周后 ,施行肿瘤切除及保留肢体功能的手术。结果 介入化疗后病理检查 ,肿瘤有不同程度的坏死 ,体积缩小 ,周围水肿浸润带减少 ,肿瘤与邻近组织术中易分离 ,术后随访 6～ 62个月 ,患肢功能基本正常。结论 对四肢软组织肉瘤侵犯大血管、骨骼者 ,术前动脉介入化疗可提高切除率 ,降低局部复发及保存患肢。

Objective To evaluate the results of intra-arterial chemotherapy and wide resection in patients with extremity soft tissue sarcoma.Methods From 1997 to 2003,21 patients with extremity soft tissue sarcoma were treated with intra-arterial chemotherapy preoperatively and limb-salvage two weeks later.Of them,13 cases (62%) were confirmed to be adherent to the major vessels and bone by ultrasonic and CT scan. After chemotherapy,the limb-salvage was undergone,resecting tumor tissues and meanwhile,preserving the main function of the extremities.Results The size of tumor decreased gradually with necrosis of the cells and the less invasive margin around tumor.Also,mass was detached easily from adjacent tissue.All cases were followed up for a period of 6-62 months,the functions of extremities of these patients remain satisfactory.Conclusions The use of intra-arterial chemotherapy and limb-salvage surgery can increase the possibility of resection and decrease the local recurrence in soft tissue sarcoma and remain the main function of affected extremity.