摘要
目的:在大剂量化疗无效的ⅢB期骨肉瘤中探讨克服耐药,提高疗效的方法,并为将此疗法应用于ⅡB期骨肉瘤做准备。方法:在4例既往大剂量化疗无效的ⅢB期骨肉瘤中进行化疗。化疗前,取自体骨髓血备用,化疗后,于氨甲喋呤血药浓度小于1.0×10^(-7)mol/L时,回输自体骨髓血。设计化疗方案为氨甲喋呤500mg/kg,阿霉素25～75mg/m^2,长春新碱1.5mg/m^2。结果:4例患者化疗后胸痛、胸闷症状缓解或明显减轻,2例肺转移瘤明显缩小,1例肺转移瘤钙化,1例肺转移瘤发展速度较化疗前减慢。结论:此疗法对常规大剂量化疗无效的耐药性ⅢB期骨肉瘤患者有效。自体骨髓移植为这一化疗方案提供了安全保证,并有望扩大治疗范围。
Objective: To study the super high-dose chemotherapy in drug-resistance Ⅲ B osteasarcoma with autologous bone marrow transplantation. Methods: The chemotherapy was carried out in 4 patients with drug-resistance Ⅲ B osteosarcoma. The autologous bone marrow was harvested before chemotherapy and reinfused after chemotherapy when the serum concentration of methotrexate reduced to 1.0×10^(-7) mol/L. The chemotherapy included ,methotrexate 500 mg/kg , adriamycin 25 - 75 mg/m^2 and vincristine 1.5 mg/m^2 with low dose citrovorum factor rescue. Results: Four patients tolerated the chemotherapy well and felt better than before. The pulmonary metastases had various degrees of reduction in 2 patient and calcified in 1 patient, but progressed in 1 patient. Conclusion: Super high-dose chemotherapy has good response in drug-resistance ⅢB osteosarcoma and is safe with autologous bone marrow transplantation. This regimen is worth to be further studied and be used in ⅡB osteosarcoma.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第12期736-739,共4页
Chinese Journal of Orthopaedics
关键词
骨肉瘤
药物疗法
骨髓移植
超大剂量化疗
Osteosarcoma Drug therapy, combination Bone marrow transplantation
