新辅助化疗加手术治疗膝部骨肉瘤

目的回顾分析以外科手术为主膝部骨肉瘤的治疗结果。方法分析自1998～2003年收住院的16例分别予截肢、单纯人工假体置换、人工假体+异体骨的膝部骨肉瘤病人治疗效果。结果截肢5例于术后1～2月安装假肢,满足日常功能需要,无心理顾虑;单纯人工假体7例,2例为可延长假体,其中1例术4月后出现多处骨肺转移而放弃治疗,另1例术后3年已延长4.5cm,所有膝关节功能(屈)70～90°(伸)170～180°,2例胫骨上段骨肉瘤术口愈合欠佳,无感染病例,股骨下段肿瘤术后膝关节功能较好。结论新辅助化疗提高了膝部骨肉瘤的保肢率,保肢抑或截肢要根据病人的具体情况而定,主要神经血管束受侵犯的不能勉强保肢,现代假肢也是合适的选择。

NEW ADJUVANT CHEMOTHERAPY COMBINED WITH OPERATION TREATING KNEE OSTEOSARCOMA

Objective To explore the result of operation+new adjuvant chemotherapy for knee osteosarcoma. Methods 16 cases of stage ⅡB and ⅡA osteosarcoma of the extremities, according to Enneking classification, were treated with Rosen T regimen chemical therapy before and after operation. Results The patients were followed up from 6 months to 3 years (30 months on average). Has found that the 3 years survival rate of limb-salvage cases increased significantly. Conclusion The extensive resection with new adjuvant chemotherapy may be the ideal treatment for osteosarcoma of the knee,which provides condition for limb-salvage and increases the survival rate. But limb-salvage or amputation should be selected according to the condition of patient.