异环磷酰胺联合顺铂治疗复发性腹膜后肉瘤的临床疗效及预后分析

Clinical efficacy and prognosis analysis of ifosfamide and cisplatin in the treatment of recurrent retroperitoneal sarcoma

目的探讨异环磷酰胺联合顺铂方案治疗在复发性腹膜后肉瘤的治疗效果及其预后。方法 55例复发性腹膜后肉瘤患者分成试验组28例和对照组27例,试验组静脉滴注顺铂20~30 mg·m-2,连续用3~5 d,3周后重复给药,治疗3~4个疗程;异环磷酰胺1.2~2.0 g·m-2,连续用药5 d,3~4周后重复给药,治疗4个疗程;对照组患者仅用异环磷酰胺治疗。观察2组患者治疗后的临床疗效,记录患者的6,12,24个月后生存状况和不良反应发生情况。结果试验组总有效率为64.25%,显著高于对照组的29.63%（P〈0.05）。试验组6,12,24个月的生存率分别为92.86%,85.71%,67.87%,对照组分别为92.59%,81.48%,55.56%,差异无统计学意义（P〉0.05）。试验组总不良反应发生率为60.71%,对照组为59.26%,差异无统计学意义（P〉0.05）。结论异环磷酰胺联合顺铂治疗复发性腹膜后肉瘤的临床疗效相对较好,能提高生存率和生活质量,值得推荐使用于临床。

Objective To explore the clinical efficacy and prognosis analysis of ifosfamide and cisplatin in the treatment of recurrent retro- peritoneal sarcoma. Methods A total of 55 cases of recurrent retro- peritoneal sarcoma patients were divided into treatment group （28 cases） and control group （27 cases）. Patients in treatment group were treated with cisplatin 20 -30 mg ~ m-2 intravenous infusion, continuous to use 3 to 5 days for a course of treatment, repeated administration three weeks later, treatment for 3 to 4 courses; ifosfamide 1.2 -2. 0 g ~ m-2 daily, 5 days a course, 3 to 4 weeks a repeat, 4 courses treatment. Patients in control group were treated with ifosfamide only. Clinical efficacy of the two groups were observed, living conditions and adverse reactions were observed after 6,12,24 months treatment. Results Total effective rate in treatment group was 64.25%, significantly higher than that （29.63%）in control group （P 〈0. 05）. Survival rates of 6, 12, 24 months in treatment group were 92. 86%, 85.71%, 67. 87%, and control group were 92.59%, 81.48% and 55.56%, with no significant difference （P 〉 0. 05）. The incidence of adverse reactions in treatment group was 60.7! %, with no significant difference with control group, which was 59.26% （P 〉 0. 05）. Conclusion The effect of ifosfamide combined with cisplatin in the treatment of re- current retroperitoneal sarcoma was relatively better, and the combination can improve the survival rate and quality of life, worth recommended to clinical use.