新辅助化疗加保肢手术治疗肢体骨肉瘤

目的评价新辅助化疗加保肢手术治疗肢体骨肉瘤的临床疗效。方法选择1994年6月至2002年6月新辅助化疗加保肢手术治疗肢体骨肉瘤17例。达到广泛切除者11例，仅达边缘切除者6例；15例接受过术前化疗的病例切除标本均做多病理切片的坏死率评估。结果17例中无瘤生存超过5年的共有9例(52．9％)，其中截肢术2例(17．6％)，肢体功能评分结果，优7例、良2例、可3例、差5例，优良率为69．9％。结论新辅助化疗加保肢手术是治疗肢体骨肉瘤患者理想的治疗方法，术前有效化疗是保肢术成功的关键。

The new adjuvant chemotherapy with limb salvage surgery for extremity osteosarcoma

Objective To evaluate the clinical curative effect of new adjuvant chemotherapy with limb salvage surgery for extremity osteosarcoma.Methods From June 1994 to June 2002,17 patients with the diagnosis of extremity osteosarcoma were treated with new adjuvant chemotherapy and limb salvage surgery.The histological evaluation of surgical margins revealed wide resection in 11 patients and marginal resection in 6 patients.Multiple histological sections were examined from each of the resected specimens in 15 patients who received preoperative chemotherapy to determine the effect of the chemotherapeutic agents.Results Of 17 cases,9 cases belonged to disease-free survival at 5 years,accounted for 52.2%,2 cases underwent amputation,accounted for 17.6%. The evaluated functional results showed and excellent or good result in 69.9% of the patients.Conclusions New adjuvant chemotherapy with limb salvage surgery is an ideal treatment for the extremity osteosarcoma.However,limb salvage procedures result in high rate of complications.Further study must be conducted to reduce local recurrence and improve reconstructive methods.