根治性放疗同步化疗治疗局部晚期尤文氏肉瘤家族肿瘤的临床效果#br#

目的评价根治性放疗同步化疗治疗局部晚期尤文氏肉瘤家族肿瘤的临床效果。方法回顾性分析2012年6月至2015年12月新疆医科大学附属肿瘤医院收治的24例局部晚期尤文氏肉瘤家族肿瘤行根治性放疗同步化疗患者的临床资料，男15例，女9例；骨病变12例，骨外病变12例；腰椎3例，骶骨3例，小腿6例，上臂3例，肩胛骨3例，锁骨3例，腰大肌3例；24例均无法广泛切除。先行4周期化疗，方案：长春新碱+阿霉素+环磷酰胺/异环磷酰胺+依托泊苷（VAC/IE）交替方案各2周期，每3周重复1次，再行调强放疗，处方剂量：56 Gy/28f，2 Gy/次，5次/周，6周完成；放疗过程中原方案同步化疗2周期，再按原方案化疗10个周期；治疗过程中，每2周期化疗后根据实体肿瘤疗效评价标准（RECIST）评估原发病灶局部情况；治疗结束后，通过定期复查进行随访。结果同步放化疗后，全组24例患者中6例完全缓解（CR），12例部分缓解（PR），6例疾病稳定（SD）；总有效率（CR+PR+SD）为100%。5年无进展生存率（RFS）为58.3%，5年总生存率（OS）为62.5%。放化疗后发生Ⅰ～Ⅱ度骨髓抑制15例，Ⅲ～Ⅳ度骨髓抑制9例；Ⅰ～Ⅱ度胃肠道反应24例，1～2级急性放射性皮炎24例。结论根治性放疗同步化疗治疗局部晚期尤文氏肉瘤家族肿瘤的效果确切，耐受性良好，对于不能手术保肢或肿瘤不可切除的患者可选择该治疗方案。

The curative effect of definitive radiotherapy and concurrent chemotherapy in locally advanced Ewing's sarcoma family tumors

Objective To investigate curative effect of definitive radiotherapy and concurrent chemotherapy in locally advanced Ewing's sarcoma family tumors.Methods 24 patients of locally advanced Ewing's sarcoma family tumors in the Affiliated Tumor Hospital of Xinjiang Medical University from June 2012 to December 2015 undergoing definitive radiotherapy and concurrent chemotherapy were retrospectively analyzed.Male 15 cases,female 9 cases;Bone lesions 12 cases,outside bone lesions 12 cases;lumbar 3 cases,sacrum 3 cases,calf 6 cases,upper arm 3 cases,shoulder blades 3 cases,collarbone 3 cases,psoas major 3 cases.24 cases were unable to wide excision.First 4 cycles chemotherapy,chemotherapy plan:VAC/IE(vincristine+adriamycin+cyclophosphamide/Ifosfamide+etoposide).Then intensity modulated radiation therapy and 2 cycles chemotherapy,meanwhile,radiotherapy prescribed dose:56 Gy/28 f,2 Gy/time,5 times/week,6 weeks to complete.Finally,after completion of concurrent chemoradiotherapy,10 cycles of chemotherapy were performed according to the original plan,then effect evaluation.During the treatment,the local condition was evaluated according to Response Evaluation Criteria in Solid Tumors(RECIST)after every 2 cycles of chemotherapy.After treatment,the patients were followed up by regular review.Results After concurrent chemoradiation,CR 6 cases,PR 12 cases,SD 6 cases;total effective rate(CR+PR+SD)was 100%.5 years of progression-free survival(PFS)rate was 58.3%,5 years of overall survival(OS)rate was 62.5%.Adverse reaction:myelosuppression,gradeⅠ-Ⅱ15 cases,gradeⅢ-Ⅳ9 cases;gastrointestinal reaction:gradeⅠ-Ⅱ24 cases;all the patients were gradeⅠ-Ⅱacute radioactive dermatitis.Conclusions The curative effect of definitive radiotherapy and concurrent chemotherapy in locally advanced Ewing's sarcoma family tumors is effective with good tolerance.This treatment is probably available for patients with inoperable limb salvage or non-resectable tumors.