局部性尤文肉瘤综合治疗临床分析

Effects of combined therapy for primary nonmetastatic Ewing's sarcoma

目的 探讨局部性尤文肉瘤的综合治疗效果。方法 收集经综合治疗的 2 5例尤文肉瘤患者的临床资料 ,采用Kaplan Meier法进行分析、Logrank法检验 ,分析治疗方式和化疗周期对疗效的影响。结果 综合治疗局部性尤文肉瘤的有效率为 92 % (2 3 /2 5 )。治疗结束后病灶完全消退组患者的 1、3、5年生存率 (10 0 %、93 .8%和 81.3 % )明显高于病灶未完全消退组 (10 0 %、75 .0 %和 5 0 .0 % ) (均P <0 .0 5 )。行 6个周期化疗的患者 1、3、5年生存率 (10 0 %、93 .8%和 66.7% )高于 3个周期者 (88.9%、77.8%和 5 5 .6% ) (均P <0 .0 1)。局部采用手术或放疗对疗效无明显影响 (P >0 .0 5 )。结论 经综合治疗 ,局部性尤文肉瘤病灶完全消退者生存期明显延长 ,化疗周期的次数是影响疗效的重要因素。

Objective To evaluate the efficiency of radiotherapy and operation plus chemotherapy for primary nonmetastatic Ewing's sarcoma. Methods A retrospective analysis was performed on 25 patients with primary nonmetastatic Ewing's sarcoma treated by radiotherapy or operation combined with chemotherapy. Kaplan-Meier analysis and Logrank test were used to evaluate the survival rates, the influence from different cycles of chemotherapy and radiotherapy and operation on treatment results.Results The 1-, 3-, 5-year survival rates were better in complete response group(100%,93.8%,81.3%,respectively) than in partial rimission (PR) and no change (NC) groups( 100%,75.0%, 50.0%,respectively), with a very significant difference (P<0.05). The 1-, 3-, 5-year survival rates in the 6 cycles group(100%,93.8%,66.7%, respectively) were better than in the 3 cycles group (88.9%,77.8%, 55.6%,respectively) (P<0.01). There was no difference between operation group and radiation group in 1-, 3-, 5-year survival rates (P>0.05). Conclusion The survival rate is better in complete remission group than in PR+NC groups. The number of chemotherapy cycles should be paid due attention.