摘要
目的 探讨胸骨肿瘤诊断和治疗的临床特点。方法 回顾性总结中国医学科学院肿瘤医院胸外科 196 7年 3月～ 2 0 0 1年 8月治疗的胸骨肿瘤 12例 ,均经病理科复核阅片。结果 软骨肉瘤5例 ,2例分别于术后 18年、2 5年非肿瘤死亡 ,3例术后分别生存 6 2个月、11个月、12个月后失访 ;骨肉瘤 1例 ,经术前、术后化疗 ,已无瘤生存 5 3个月 ;恶性纤维组织细胞瘤 1例 ,术后无瘤生存 17个月后失访 ;骨巨细胞瘤 1例 ,术后无瘤生存 6 6个月 ;淋巴瘤 1例 ,术后生存 17个月 ;脂肪肉瘤 1例 ,未手术 ,生存 2 8个月后失访 ;转移性腺癌 2例 ,其中放化疗 1例生存 7个月 ,手术 1例生存 2 7个月。结论 治疗胸骨肿瘤术前必须先明确病理类型 ,软骨肉瘤、恶性纤维组织细胞瘤宜选择手术切除 ;骨肉瘤应选择化疗 +手术 ;而浆细胞瘤、淋巴瘤、Ewing肉瘤可采用非手术治疗 ,若手术应严格筛选。胸壁重建可应用人工合成物和转移性肌皮瓣。
Objective To exami ne the efficacy and investigate the advance in the treatment,sternal tumors.Me thods From March 1967 to August 2001,12 patients underwent surgical treatment,chemotherapy or radiotherapy for pathologically confirmed sternal tumors at our Cancer Institut e(Hospital),CAMS.Results Of five patients wi th chondrosarcoma treated by resection,two died not of tumor,and had been alive for 18 years and 25 years,respectively; three had been alive for 62 months,11 months a nd 12 month s ,respectively,before they were lost to follow-up.A patient with osteosarcoma remains al ive and well 53 months after operation and adjuvant chemotherapy.One patient wit h alignant fibrous histiocytoma had been alive for 17 months after resection,be fore being lost to follow-up.A patient with bone giant cell tumor survived for 66 months free of tumor after operation.One patient with lymphoma was alive for 11 months af ter resection.A patient with liposarcoma treated nonsurgically received radiothe rapy and chemotherapy,and was lost to follow-up at 28 months.Two patients had sternal metastasis of adenocarcinoma of unknown origin.One of them treated with radiotherapy and chemotherapy survived for 7 months and the other treated surgic ally survived for 27 mo nths.Conclusions It is important to identify primary sternal tumors patholog ically before treatment,because the survival of these patients is tumor depend en t.Most solid tumors,notably chondrosarcoma,are potentially curable by extensive surg ical excision.Patients with osteosarcoma are advised to undergo resection and pe rioperative chemotherapy.Treatment of lymphoma,plasmocytoma and Ewing′s sarco ma is nonsurgical,except when the diagnosis is in doubt or as a salvage operati on if the tumor is still localized after radiation therapy and chemotherapy.The chest wall can be reconstructed with prosthetic materials and transposed muscul ocutaneous flaps.
出处
《中国肿瘤临床与康复》
2004年第3期250-252,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
胸骨肿瘤
治疗
Sternum neoplasms
Therapy
