骨肉瘤的治疗进展

Progress on treatment of osteosarcoma: a review of the literature

骨肉瘤（osteosarcoma,OS）是儿童和年轻成年人中最常见的原发肉瘤,并在10~20岁人群及老年人群中形成典型的双高峰分布。OS总体而言治疗策略类似,包括新辅助化疗、手术切除肿瘤并重建肢体功能以及高剂量化疗的系统疗法。随着手术技术的进步,需要截肢手术的患者明显减少,保肢手术成为主要的手术方式。随着治疗理念与化疗水平的改进,OS的生存率已由原先的不到30%升高到70%以上,但近几十年来疗效上没有本质上的提高,尤其是对转移的患者。本综述总结了治疗OS的主要进展、目前已有的标准治疗方案、手术策略以及分子靶向治疗研究领域的进展。

Osteosarcoma is the most frequent primary sarcoma in children and young adult population. It has a typical double- peaks distribution in the 10- 20 years old population and late adulthood. The therapy strategy for all type of osteosarcoma is similar,including neoadjuvant chemotherapy,tumor resection with restoration of limb function and postoperative chemotherapy. Due to the progress of the surgery technique,the amount of patients who need amputation decreased and the operation with salvage of limbs has become the main surgery protocol. Due to the modification of therapy concept and chemotherapy protocol,the survivorship rate of osteosarcoma patients increased from less than 30% to more than 70%,but in the recent decades,the progress of the therapy effects has not been substantially improved,especial for the metastatic patients. This review has summarized the main progress of the osteosarcoma therapy,the standard therapy protocol at present,surgery strategy and the progress of molecular targeting treatment.