新辅助化疗联合保肢手术治疗骨肉瘤的近期疗效观察

The clinical effects of neoadjuvant chemotherapy combined with limb salvage in patients with osteosarcoma

目的探讨新辅助化疗联合保肢手术治疗骨肉瘤的临床疗效。方法 40例四肢骨肉瘤患者随机分为试验组和对照组,试验组患者采用新辅助化疗联合保肢手术治疗,对照组患者采用截肢手术治疗。两组患者手术后均给予化疗,同时对比分析两组患者的临床疗效。结果试验组和对照组分别有3例和11例患者出现复发和(或)转移(P<0.05)。两组患者的术后1年和2年生存率差异无统计学意义,但试验组患者的术后3年生存率高于对照组(P<0.05)。两组患者的临床疗效优良率比较,试验组优于对照组(P<0.05)。试验组患者肢体功能评分为(23.5±4.6)分,而对照组为(11.8±3.1)分,两组比较,差异有统计学意义(P<0.05)。结论新辅助化疗联合保肢手术治疗骨肉瘤能够保证患者的生存率,其局部复发率和转移率与截肢手术一致,同时保存了患者肢体,提高了患者的生活质量,值得临床推广。

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with limb salvage in patients with osteosarcoma. Methods 40 patients with limb osteosarcoma were divided into the observation group and the control group. The patients in the observation group received neoadjuvant chemotherapy and limb salvage, while the patients in the control group were treated with amputation, and all of the patients received chemotherapy after surgery. The clinical effects of the two groups were compared. Results Three patients in the observation group had been observed recurrence or metastasis,while 11 cases observed in the control group（P 〈0. 05 ）. There was o significant difference between the two groups in postoperative 1-year and 2-year survival rate, however, the 3-year survival rate in the observation group was significantly higher than in the control group （ P 〈 0. 05 ）. The good rate of the observation group was also better than the control group （ P 〈 0.05 ）. The limb function score for the study group and the control group were 23.5 ± 4, 6 and 11.8 ± 3. 1, respectively （P 〈 0. 05）. Conclusion Neoadjuvant chemotherapy combined with limb salvage in patients with osteosarcoma did not increase the rate of local recurrence and metastasis, meanwhile ,it greatly improved the quality of life.