骨肉瘤新辅助化疗模式的临床疗效观察

Clinical study on the new adjuvant chemotherapy for the treatment of osteosarcoma

目的探讨骨肉瘤新辅助化模式的临床疗效与毒副作用。方法将38例骨肉瘤患者分为新辅助化疗组与辅助化疗组,新辅助化疗组20例术前化疗1～2个疗程,术后化疗4～6个疗程。辅助化疗组仅给予术后化疗4～6个疗程。根据肿瘤坏死率调整术后化疗方案,并评价两组疗效及毒副作用。结果新辅助化疗组中肿瘤坏死率测定:>90%14例,<90%6例。术后2年转移率为25.0%,2年生存率为80.0%,临床疗效好于辅助化疗组。结论新辅助化疗模式在降低患者术后转移率及提高患者的生存率方面有一定优势,是治疗骨肉瘤的理想方法。

Aim To evaluate the clinical and side effects of the new adjuvant chemotherapy for the treatment of osteosarcoma.Methods 35 cases were divided into the new adjuvant chemotherapy and adjuvant chemotherapy groups. 20 cases in the new adjuvant chemotherapy group were treated with preoperative ultra-high dose chemotherapy for one or two periods,and postoperative chemotherapy for 4～6 courses.Postoperative chemotherapy regimen was adjusted according to the tumor necrosis rate.15 cases in another group were treated only with postoperative chemotherapy for 4~6 courses. The clinical and adverse effect of these two groups were evaluated.Results In the group of new adjuvant chemotherapy,the tumor necrosis rate was over 90% in 14 cases,under 90% in 6 cases.2-year metastasis rate and 2-year survival rate after surgery were 25.0% and 80.0%,respectively.And the clinical effect was better than that in the adjuvant group.The main adverse effects in the chemotherapy were myelosuppression,gastriotestinal reaction,the damage of liver and renal function.ConclusionThe new adjuvant chemotherapy can decrease the metastsis rate and increase the survival rate in osteosarcoma patients,and it is an ideal therapy for osteosarcoma.