综合治疗骨肉瘤保留肢体30例临床观察

目的 观察综合治疗四肢骨肉瘤保肢的临床疗效。方法 对30例四肢骨肉瘤病人，根据病变部位、范围、Enneking分期，分别进行了瘤骨灭活再植、在体灭活、局部扩大切除、骨水泥填充、瘤骨切除后自体骨移植关节重建，以及术前、术后局部化疗及放疗。结果 随访0．5～11年，发现30例病人中感染3例，病理骨折1例，腓总神经损伤2例，局部复发6例；2年无瘤生存24例(80％)，3年无瘤生存20例(66．7％)，5年无瘤生存16例(53．3％)。结论 手术及手术前、后采用局部动脉化疗及局部放疗，是四肢骨肉瘤保肢术的较为理想方法。

CLINICAL OBSERVATION ON LOCAL CHEMOTHERAPY AND RADIOTHERAPY IN TREATING OSTEOSAR COMA AND PRESERVING LIMBS

Objective To observe the clinical effect of synthetic treatment of osteosarcoma in limbs. Methods 30 cases of osteosarcoma were classified according to their lesion position, range and Enneking stages and were treated by inactivation and reimplantation in vivo, cement filling in bones, auto- grafting to reconstruct joints and local chemotherapy and radiotherapy. Results According to the follow- up surveys lasting 0. 5 ~ 11 years,infections occurred in one case, injury of common peroneal nerves in 2 cases, local recurrence in 6 cases, survival without tumors for 2 years in 24 cases(80%), survival without tumors for 3 years in 20 cases(66.7% ) and survival without tumors for 5 years in 16 cases (53.3%). Conclusion Local chemotherapy and radiotherapy in arteries can effectively treat osteosarcoma and preserve limbs.