摘要
目的评价采用保肢和截肢术结合化疗对Ⅱ期四肢骨肉瘤患者的临床疗效。方法分析1996年1月～2007年7月山西医科大学第二医院骨科收治确诊的68例肢体骨肉瘤患者的临床资料,其中48例行保肢术治疗,20例行截肢术。术前、术后均进行化疗。63例患者获随访,随访时间6～63个月,平均38.5个月。将随访时间达3年的53例骨肉瘤患者分为保肢组和截肢组,以3年生存率、局部复发率以及术后的功能恢复评价为指标进行比较。结果在53例肢体骨肉瘤患者中,保肢组3年生存率为51.4%,局部复发率为8%,按照国际保肢协会推荐使用的肿瘤术后功能重建评价系统平均为26分。截肢组3年生存率为50%,局部复发率为6%,术后功能评分平均为12分。统计学检验比较保肢术和截肢术术后3年生存率无显著性差异(P>0.05)。结论在术前、术后辅助化疗的基础上,保肢组的3年生存率、局部复发率与截肢组相似,并且保肢术后功能恢复满意,故采用保肢术治疗同期肢体骨肉瘤患者疗效优于截肢术。
Objective To evaluate the effect of limb-salvage treatment and amputation combined with chemotherapy for stage II osteosarcoma of the extremities. Methods The clinical data of 68 patients who were diagnosed with limb steosarcoma were analyzed. Among them, 48 patients underwent limb-salvage surgery, and 20 patients underwent amputation. All patients underwent preoperative and postoperative chemotherapy. 63 patients were followed up for 6 to 63 months. The mean follow-up was 38.5 months. 53 patients （follow-up 〉3 years） were devided into limb-salvage treatment group and amputation treatment group. The two groups were compared with respect to 3-year survival rate, local recurrence rate and the functional evaluation of reconstructive procedures. The difference in 3-year survival rate of the two groups was compared by log-rank test. Results Among 53 patients, in the limb-salvage surgery group, the 3-year survival rate was 51.4%, the local recurrence rate was 8%, and the functional evaluation of reconstructive procedures after surgical treatment was 26 points. In amputation patients, the 3-year survival rate was 50%, the local recurrence rate was 6%, and the functional evaluation of reconstructive procedures after surgical treatment was 12 points. There was no significant difference between the two groups in 3-year overall survival rate （P〉0.05）. Conclusions Combined with preoperative and postoperative chemotherapy, limb-salvage and amputation surgery would lead to a similar 3-year survival rate and local recurrence rate, and the functional evaluation of reconstructive procedures was satisfactory. The clinical outcome of limb-salvage treatment was superior to amputation treatment.
出处
《中国骨肿瘤骨病》
2010年第2期136-139,共4页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
骨肉瘤
保肢治疗
截肢术
化疗
Osteosarcoma
Limb-salvage
Amputation
Chemotherapy
