胫骨成骨肉瘤的保肢治疗

Limb salvage of osteosarcoma in tibia

目的 探讨胫骨成骨肉瘤的保肢治疗。方法 对 1992年～ 2 0 0 1年收治的胫骨成骨肉瘤 75例 ,采用插入式微波天线阵列诱导高温原位灭活 ,辅以手术前、后化疗及术后免疫治疗 ,并按Enneking标准评价肢体关节功能。结果 平均随访 4 5年 ,术后 6个月～ 2 2年内因肿瘤转移而死亡者 17例 ,存活 5 8例 ,存活率77 3%。存活者中 ,3例因局部复发而截肢 ,1例复发者行瘤段截除大段异体骨植骨融合。对 5 8例肢体关节功能评价 :优 39例 ;良 15例 ;因复发行瘤段截除大段异体骨融合者可 ;3例截肢者配带假肢功能差。结论 插入式微波天线阵列诱导高温原位灭活胫骨成骨肉瘤 ,并辅以化疗、免疫治疗 ,安全、有效 ,可望普及推广。

Objective To discuss the limb salvage of tibial osteosarcoma.Methods To evaluate the limb and joint function of the hyperthermia induced by inserted microwave antenna arrays to treat 75 cases with the tibial osteosarcoma,and assisted with chemotherapy and immunotherapy pre and postoperatively,who were in-patient from 1992 to 2001.Results The follow-up averaged 4.5years.Seventeen cases dropped out within postoperative 6 months～2.2 years because of metastasis while 58 cases survived,the survival rate was 77.3%.Among survivors,3 cases sufferred from amputation while one was performed with tumor resection and bone allograft.The survivors'joint function was assessed as follows:39 cases excerllent,15 good and 1 fair who accepted bone allograft,3 poor who were amputated and installed with artificial limb.Conclusion The hyperthermia induced by inserted microwave antenna arrays to treat the tibial osteosarcoma,assisted with chemotherapy and immunotherapy pre and postoperatively,is safe and efficient.It may be used broad clinically.