肢体骨肉瘤以介入为主的综合治疗

Interventional combined therapy for osteosarcoma of the extremities

目的 探讨介入性综合治疗方法治疗肢体骨肉瘤的效果。方法 11例经病理证实的肢体骨肉瘤 (临床分期ⅡB 10例 ,Ⅲ期 1例 ) ,给予介入为主的综合治疗。 1、经股动脉顺行插管埋置药盒导管系统后 ,行动脉内局部灌注及全身化疗两个疗程。 2、动脉内局部小剂量灌注及同时放疗。 3、再予全身化疗 ,每月 1次 ,共 6个疗程。所有病例均随访 12～ 46个月。结果 所有患肢均得以保留 ,疼痛症状消失 ,功能改善 ,肿瘤局部控制率为 90 .9% ,复发率为 9.1%。 1、2、3年的累积生存率 (含带瘤生存 )分别为 10 0 %、87.5 0 %、75 %。结论 对肢体骨肉瘤采用介入为主的综合治疗 ,能获得良好的肿瘤局部控制及保肢目的。

Objective To investigate the efficacy of interventional combined therapy in the management of osteosarcoma of the extermities. Methods Consecutive cases of osteosarcoma of the extremities were confirmed pathologically. 7 of them were male and 5 were female, the age ranged 7 to 37 years, 5 lesions involved with tibia, 6 occursed on femur. 10 cases were in the stage of ⅡB, only l in stage Ⅲ. They were treated with the “three stage protocol”:1) after the implantation of port catheter system in the femoral artery, intraarterial infusion and systemic chemotherapy were performed every month for 2 cycles. 2). Intraarterial infusion and sectional radiation were administered concurrently for 2 cycles. 3). Chemotherapy were given again for 6 cycles. All the cases were followed up (ranged 12 to 46 months). Results All the patient's limbs were retained; the clinical symptom and function improved markedly. The regional control rate of the tumor was 90.9% and the rate of recurence was 9.10%. The accumulative survival rates of 1, 2, 3 years were 100%, 87.5%, 75%, respectivly. Conclusions The interventional combined therapy protocol is effective to control the local focus and saving limbs in the management of osteosaroma of the extxemities.