采用以保肢手术为主的综合治疗方案治疗肢体恶性肿瘤

Limb salvage operation and adjuvant chemotherapy for the treatment of malignant tumor of limb

近１０余年肢体恶性肿瘤的治疗获得了突破性成功。１９８３年以来，我们采用包括术前和术后辅助化疗及肿瘤根治切除、肢体功能重建方案治疗肢体恶性肿瘤１８例。我们体会：（１）恶性肿瘤必须采取以手术为主的综合治疗措施，其中大剂量联合用药化疗在确保保肢手术成功，提高手术后的成活时间起着十分重要作用。（２）保肢手术必须遵循肿瘤根治原则，同时提出了保肢手术的５条适应证。（３）保肢手术必须根据患者年龄、肿瘤部位及恶性程度、病期的早晚、全身条件等选择最宜的手术方法。

patients with musculoskeletal tumor treated by surgical resection and preoperative and postoperative adjuvant chemotherapy since 1983 were reported. The methods of the reconstruction of the limb included: free fibular transplantation, rotation plasty and artifical arthroprothesis replacement. The patients were followed up for 5.2 years (2 12 years). The 2 ,3 and 5 year disease free survival rates were 72%, 61% and 56% respectively. We consider that: (1) It is necessary to use multiple treatment regime for the malignant tumor (2) the principle of radical resection of tumor must be followed when limb salvage operation was undertaken: (3) the methods of reconstruction of limb must be chosen according to the patient's age, the location of tumor, the malignant degree of the tumor, the course of disease, the patient's condition and the hospitals technique condition, etc