骨肉瘤的大剂量化疗

本文报告ＨＤＭＴＸＣＦＲ治疗原发性骨肉瘤１８例的临床疗效，所有病例除一例经Ｘ线诊断外，余经病理学确诊。ＭＴＸ每疗程剂量０．５～３．０／Ｍ￣２，静滴ＭＴＸ开始至ＣＦ解救时间为１６～１８小时，其毒副反应轻，无一例发生意外。骨肉瘤术后辅助化疗后２年生存率５５．６％，生存５年以上者３例。本文提示，骨肉瘤的辅助化疗有肯定疗效，ＨＤＭＴＸ为有效的辅助化疗方案之一，但剂量不宜过低，只要注意水化，尿碱化及ＣＦ解救，此疗法是安全的。

High Dose Chemotherapy for Osteogenic Sarcoma

cases of osteogenic sarcoma treated with high-dose methotrexate(HDMTX)in our hospital from 1988 to 1993 are reported, which were proven by histopathology except one by X-ray.HDMTX was administrated to all patients at a dose of 0. 5 g/m to 3. 0 g/m with intravenous hydration and alkalization. Leucovorin was begun 16 to 18 hours after the start of the methotrexate infusion at a dose of 12 mg every 6 hours for three days. The 2-year overall survival was 55. 6%(10/18) for patients with osteogenic sarcoma after receiving postoperative HDMTX chemotherapy and the 5-year overall survival 15. 2% (3/18). The report suggests that the value of adjuvant chemotherapy for osteogenic sarcoma seems well established, HDMTX is one of the effective adjvant chemotherapy regimens and considerably less toxic when administrated with appropriate dose, hydration, alkalinization, and leucovorin rescue.