新辅助化疗与保肢手术治疗骨肉瘤患者的临床疗效研究

Clinical Efficacy of Neoadjuvant Chemotherapy and Limb Salvage Surgery in the Treatment of Osteosarcoma

目的:探究新辅助化疗与保肢手术治疗骨肉瘤患者的临床效果。方法:选择2015年7月—2017年3月郑州大学第一附属医院收治的82例骨肉瘤患者,采用随机数字表法分为两组,每组各41例。对照组行保肢手术治疗,研究组在对照组基础上联合新辅助化疗。对比两组临床疗效、肢体功能评分、优良率及预后情况。结果:研究组治疗总有效率为87.80%,高于对照组的65.85%,差异有统计学意义(χ^(2)=5.549,P<0.05),研究组治疗后肢体Enncking评分为(25.94±2.85)分,高于对照组的(23.79±3.61)分,肢体功能优良率为82.93%高于对照组的63.41%,差异有统计学意义(χ^(2)=3.976,P<0.05),研究组平均生存时间为(33.95±1.86)个月长于对照组(29.73±1.69)个月,3年生存率为87.80%高于对照组的58.54%,局部复发及转移率为9.76%低于对照组的36.59%,差异有统计学意义(χ^(2)=8.289,P<0.05),两组1年、2年生存率比较,差异无统计学意义(P>0.05)。结论:新辅助化疗与保肢手术治疗骨肉瘤疗效确切,在保留肢体的基础上能够进一步提升近期及远期疗效,降低局部复发及转移率,值得推广应用。

Objective:To explore the clinical effect of neoadjuvant chemotherapy and limb salvage surgery in the treatment of osteosarcoma.Methods:82 patients with osteosarcoma in the hospital from July 2015 to March 2017 were selected and randomly divided into two groups,with 41 cases in each group.The control group received limb salvage surgery,while the study group received neoadjuvant chemotherapy on the basis of the control group.The clinical efficacy,limb function score,excellent and good rate and prognosis of the two groups were compared.Results:The total effective rate of the study group was 87.80%,higher than65.85% of the control group,the difference was statistically significant(χ^(2)=5.549,P<0.05).The limb enncking score of the study group after treatment was(25.94±2.85) points,higher than(23.79±3.61) points of the control group.The excellent and good rate of limb function was 82.93%,higher than 63.41% of the control group,the difference was statistically significant(χ^(2)=3.976,P<0.05).The average survival time of the study group was(33.95±1.86) months,which was longer than(29.73±1.69) months of the control group.The 3-year survival rate in the study group was 87.80%,which was higher than 58.54% in the control group,and the local recurrence and metastasis rate was 9.76%,which was lower than 36.59% in the control group.The difference was statistically significant(χ^(2)=8.289,P<0.05).There was no statistically significant difference in the 1-year and 2-year survival rate(P>0.05).Conclusion:Neoadjuvant chemotherapy and limb salvage surgery are effective in the treatment of osteosarcoma.On the basis of limb preservation,it can further improve the short-term and long-term efficacy,reduce the local recurrence and metastasis rate,which is worthy of promotion and application.