一线化疗联合三氧化二砷对肢体转移性骨肉瘤的疗效分析

发布时间：2018-03-12 13:18

  本文选题：骨肉瘤　切入点：肺转移　出处：《中国肿瘤临床》2017年10期 　论文类型：期刊论文

【摘要】：目的:通过回顾北京大学人民医院骨与软组织肿瘤中心十年以上的肢体骨肉瘤肺转移的病例,对其预后、治疗过程进行总结,以期发现三氧化二砷(arsenic trioxide,ATO)联合一线化疗药物对早期肺转移病例的疗效。方法:回顾性分析北京大学人民医院骨肿瘤科自1998年3月至2014年12月收治的肢体骨肉瘤肺转移的连续病例,挑选出治疗过程中出现早期肺转移及初治肺转移曾经使用过ATO长期输液联合一线化疗药物(阿霉素、顺铂、大剂量氨甲喋呤和异环磷酰胺)进行治疗的病例。共计119例符合本研究条件,65例为初治肺转移,54例为治疗过程中发现肺转移。结果:该组的病例经治疗,2年及5年总生存率分别为52.6%和30.9%。虽然仅20例接受了肺部切除手术(16.8%),但本中心选择治疗后的病例5年总生存情况和国际上其他区域的的生存情况类似(意大利Rizzoli的5年生存率为37%)。通过比较各项临床病理学因素,发现骨转移、双侧肺转移、出现≥3个肺转移结节以及不完全切除肺内病灶,提示患者预后不佳。结论:ATO合并一线化疗可能是一种有效且患者可耐受的新的治疗选择。肺切除手术应该严格挑选合适的病例,以获得最大的临床受益。
[Abstract]:Objective: to review the prognosis and treatment process of osteosarcoma and lung metastasis of extremities in the center of bone and soft tissue tumor of people's Hospital of Peking University for more than ten years. In order to find out the curative effect of arsenic trioxide combined with first line chemotherapeutic drugs in the treatment of early lung metastasis. Methods: retrospective analysis was made on the treatment of limb osteosarcoma in the department of bone oncology, people's hospital of Peking university from March 1998 to December 2014. Consecutive cases of metastasis, Select early lung metastases and primary lung metastases that have been treated with ATO long-term infusion plus first-line chemotherapeutic drugs (adriamycin, cisplatin, cisplatin, adriamycin, cisplatin). Large doses of methotrexate and isocyclophosphamide). A total of 119 patients met the conditions in this study. 65 patients with primary lung metastasis were found in the course of treatment. Results: patients in this group were treated for 2 years and 5. The total annual survival rates were 52.6% and 30.90.Although only 20 patients underwent pulmonary resection, the overall survival of the patients selected by our center was similar to that in other regions of the world (5-year old in Rizzoli, Italy). The survival rate was 37%. By comparing various clinicopathological factors, Bone metastasis, bilateral lung metastasis, 鈮，

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