介入治疗在骨组织肿瘤临床治疗中的价值

Clinical Application of Interventional Therapy for Bone Tumors

目的：探讨介入治疗在骨组织肿瘤临床治疗中的价值。方法：31例骨组织肿瘤患者均接受动脉化疗和／或栓塞术，部分患者于栓塞后2～15d行外科手术；未行手术患者继续采用动脉化疗和栓塞治疗，同时加放疗、静脉化疗等综合治疗，观察临床效果。结果：21例进行了肿瘤完全切除或扩大根治术，其中6例股骨肉瘤患者局部刮除并行人工膝关节置换术；10例未进行手术治疗，加行放疗、化疗等综合治疗。手术病例术中出血量明显减少，平均术中失血为1170ml，显示肿瘤缩小、软化、组织坏死。其中统计的20例原发恶性肿瘤患者1年生存率为90％，2年生存率为75％，9例患者5年生存率44．4％。结论：介入治疗是骨组织肿瘤的有效治疗方法，术前栓塞治疗可大大减少术中出血，动脉化疗栓塞作为综合治疗的重要手段能有效延长患者生存期和提高生存质量。

Objective： To investigate the clinical value of interventional treatment for bone tumors. Metheds： 31 patients with bone tumor were treated with trans-arterial infusion （TAD and （or） transcatheter arterial embolization （TAE）. Part of the patients underwent surgical operation 2-15d after embolization; those patients who didn＇t received surgery continued to use TAI and TAE. Additional radiotherapy and intravenous systemic chemotherapy were used. The clinical outcome was observed. Results： In 21 cases ,complete resection or expanded excision of the tumors were achieved ; among them, 6 cases had local curettage of femur bone sarcoma and artificial knee joint replacement. Bleeding during surgical operation was obviously decreased after interventional therapy, the average blood loss was 1170ml. Shrinkage, softening and necrosis of the tumors could be assessed. For the 10 patients didn＇t undertake surgical operation,comprehensive therapy including radiotherapy,chemotherapy was performed. Of the 20 cases with primary malignant tumor,the 1 year-,2 year-,5 year- （9 patients） survival rate was 90%, 75 % and 44.4% respectively. Conclusion.. Interventional therapy is an effective method for the treatment of malignant bone tumors,marked reduce of bleeding during surgical operation could be achieved. As a part of comprehensive therapy,TACE could effectively prolong the survival and improve the life quality of the patients.