摘要
目的 :观察以大剂量甲氨喋呤、异环磷酰胺和阿霉素组成的MMIA方案术前化疗后骨肉瘤的影像学变化 ,评价其在检测骨肉瘤化疗疗效中的价值。方法 :应用MMIA治疗 1 2例骨肉瘤。年龄为 5～ 39岁 ,男 3例 ,女 9例。股骨远端 5例 ,胫骨近端 4例 ,股骨近端、腓骨近端和髂骨各 1例。所有患者于术前化疗过程中行动态影像学检查 ,并计算术后标本的肿瘤细胞坏死率。所有患者均行保肢治疗。结果 :化疗后 1 2例患者中 1 1例临床症状缓解 ,1 0例疼痛消失 ;1 0例X线片显示肿瘤明显缩小、钙化 ,边界清晰 ,软组织肿胀影消失 ;1例变化不大 ,另 1例示肿物增大。 3例MRI显示化疗后肿瘤周围水肿消失 ,边界清晰 ,肿瘤缩小。术后肿瘤细胞坏死率Ⅳ级 3例 ,Ⅲ级 4例 ,Ⅱ级 3例 ,Ⅰ级 2例。 1 1例进行了 3个月～ 3年随访 ,除 3例于术后死亡 ,1例肺转移外 ,余 7例未见异常。结论 :术前MMIA治疗后 ,骨肉瘤的影像学变化与术后肿瘤细胞的坏死率相一致。
Objective:To study the radiological changes of osteosarcoma after chemotherapy with MMIA scheme (HDMTX,IFO and ADR).Methods:12 patients (male 3,female 9,aged 5 to 39 years) of osteosarcoma were treated with MMIA preoperatively.5 cases were involved in the distal femurs,4 cases in the proximal tibia and the remainder 3 cases in the proximal femurs, the upper end of fibula and the ilium respectively.During chemotherapy,dynamical radiological examination were done in all patients.12 cases underwent salvage limb operations,and tumor cell necrosis rate (TCNR) of postoperative samples were calculated.Results:Clinical symptoms of 11 cases alleviated,pains of 10 cases diminished,lessening and calcifications of tumor were found in 10 X ray films after chemotherapy,3 cases were in Ⅳ grade of TCNR,4 in Ⅲ,3 in Ⅱ,2 in Ⅰ.The follow ups were done in 11 cases with the range from 3 months to 3 years.Three of them died and one lung metastasis.Conclusion:Dynamical radiological examination plays an important role in assessing responds of osteosarcoma to preoperative chemotherapy.
出处
《放射学实践》
2003年第4期261-263,共3页
Radiologic Practice
