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目的 评估骨肉瘤辅助化疗方案的中远期疗效。方法 1989 年1 月～1995 年12 月采用我们制定的以国产铂类药物和阿霉素为主的方案治疗ⅡB 期肢体骨肉瘤共67 例, 其中男47 例, 女20例;年龄10 ～51 岁,平均20 岁。股骨下端45 例,胫骨上端14 例,腓骨上端和肱骨上端各3 例,股骨上端2例。成骨细胞型51 例,成软骨细胞型6 例,成纤维细胞型5 例和其他类型5 例。根据化疗的具体方法可将本组资料分成三组: 术前顺铂高温隔离肢体灌注化疗结合术后化疗23 例; 术前卡铂高温隔离肢体灌注化疗结合术后化疗20 例和仅接受术后化疗24 例。手术方法: 截肢或关节离断35 例, 保肢29 例和Tikhoff- Linberg 手术3 例。所有接受高温隔离灌注化疗病例的手术标本均以多切片进行肿瘤细胞坏死率评估。以SPSS7-0 统计软件包进行统计学处理。结果 经过3 ～9 年的随访,术后1 年内复发或转移6 例,术后1 ～2 年内复发或转移20 例,术后2 ～3 年内复发或转移4 例,术后3 年5 个月1 例保肢病例局部复发;术后4 年5 个月和5 年6 个月发生肺部转移各1 例。截肢组35 例和Tikhoff - Linberg 手术3 例无一例局部复发,保肢29 例中局部复发3 例。67 例二年无瘤生存41 例(61-19 % ) ,三年无瘤生存37 例(55-22 % ) , 五年无瘤生存可能率为(49-56 % ) 。统?
Objective To evaluate the long-term efficacy of adjuvant chemotherapy for osteosarcoma. METHODS: From January 1989 to December 1995, 67 patients with stage IIB limb osteosarcoma were treated with the platinum-based drug and doxorubicin-based regimen. Among them, 47 were male and 20 were female; aged 10 to 51. Years old, an average of 20 years old. There were 45 cases of the lower femur, 14 cases of the upper end of the sacrum, 3 cases of the upper end of the sacrum and 3 cases of the upper end of the sacrum, and 2 cases of the upper end of the femur. There were 51 cases of osteoblast type, 6 cases of chondrocyte type, 5 cases of fibroblast type and 5 cases of other types. According to the specific method of chemotherapy, this group of data can be divided into three groups: Preoperative cisplatin hyperthermia isolated limb perfusion chemotherapy combined with postoperative chemotherapy in 23 cases; Preoperative carboplatin high temperature isolated limb perfusion chemotherapy combined with postoperative chemotherapy in 20 cases and only after surgery 24 cases of chemotherapy. Surgical methods: 35 cases of amputation or joint disconnection, 29 cases of limb salvage and 3 cases of Tikhoff-Linberg operation. All surgical specimens undergoing high-temperature isolation and infusion chemotherapy were evaluated by multiple sections for necrosis rate of tumor cells. Statistical analysis was performed using the SPSS7-0 statistical software package. Results After 3 to 9 years of follow-up, recurrence or metastasis occurred in 6 cases within 1 year after surgery, 20 cases relapsed or metastasized within 1 to 2 years after operation, 4 cases relapsed or metastasized within 2 to 3 years after operation, and 3 years and 5 months after operation. One case of limb salvage had local recurrence; one lung metastasis occurred at 4 years 5 months and 5 years 6 months. There were no local recurrences in 35 patients in the amputee group and 3 in the Tikhoff-Linberg operation. There were 3 cases of local recurrence in the limb salvage in 29 cases. Sixty-one patients had 41 cases (61-19%) of tumor-free survival, three years of tumor-free survival (37 cases, 55-22%), and five years of tumor-free survival (49-56%). System?