新辅助化疗结合保肢手术治疗肢体骨肉瘤

The New Adjuvant Chemotherapy Combined with Limb Salvage Surgery for Treatment of Extremity Osteosarcoma

目的:评价新辅助化疗结合保肢手术治疗肢体骨肉瘤的临床疗效。方法:选择1995年1月～2003年1月新辅助化疗结合保肢手术治疗的肢体骨肉瘤31例。广泛切除22例,边缘切除9例。所有病例切除标本均做多病理切片的坏死率评估。结果:随访2～8年,31例中无瘤生存超过5年19例(61.3%),肿瘤局部复发4例(12.9%)。肢体功能评估优良率为67.7%。结论:新辅助化疗结合保肢手术是治疗肢体骨肉瘤理想的治疗方法,术前有效化疗是保肢术成功的关键。

Objecttive： To evaluate the clinical effectiveness of new adjuvant chemotherapy in combination with limb salvage surgery for treatment of extremity osteosarcoma. Methods： A total of 31 patients with extremity osteosarcoma were treated by new adjuvant chemotherapy combined with limb salvage surgery. The histological evaluation of surgical margins revealed wide resection in 22 patients and marginal resection in 9 patients, Multiple histological sections were examined from each of the resected specimens to determine the effect of the chemotherapeutic agents. Results： All patients were followed-up with 2 to 8 years. Among 31 cases, 19 （61.3%） belonged to disease-free survival at 5 years, 4 （12.9%） had local recurrence. The evaluated functional result revealed an excellent or good result in 67.7% of the patients. Conclusions： The new adjuvant chemotherapy combined with limb salvage surgery is an ideal treatment method for treatment of extremity osteosarcoma. An effective preoperative chemotherapy make limb salvage surgery successful.