异环磷酰胺联合顺铂、聚乙二醇脂质体多柔比星方案治疗骨肉瘤的疗效及不良反应

目的:探讨异环磷酰胺联合顺铂、聚乙二醇脂质体多柔比星方案治疗骨肉瘤的疗效及不良反应。方法:选取骨肉瘤患者36例，接受聚乙二醇脂质体多柔比星剂量20 mg/m2，静脉滴注，第1天；异环磷酰胺剂量2.0 g/m2，静脉滴注，第1～5天；顺铂剂量80 mg/m2，静脉滴注，第8天；每21天一个周期。化疗期间行手术治疗。结果:32例患者完成8个周期化疗。25例患者存活，22例患者无瘤生存，中位无瘤生存时间为40.2个月(22.5～57.3个月)。化疗后3/4级不良反应包括白细胞下降6例(16.7%)、粒细胞下降8例(22.2%)、贫血1例(2.8%)和呕吐2例(5.6%)。25例长期生存患者的MSTS 93评分为16~30分，平均22.2分，优良率为80.0%；SF-36量表显示患者活力得分较低。结论:临床应用异环磷酰胺、顺铂、聚乙二醇脂质体多柔比星方案联合手术治疗骨肉瘤疗效确切，且不良反应较轻，值得进一步深入研究和推广。

Effects and adverse reactions of ifosfamide combined with cis-platinum and pegylated liposomal doxorubicin on osteosarcoma

Objective:To investigate the effects and adverse reactions of ifosfamide combined with cis-platinum and pegylated liposomal doxorubicin on osteosarcoma.Methods:36 patients with osteosarcoma were selected.They received pegylated liposomal doxorubicin 20 mg/m2，ivgt d1,ifosfamide 2.0 g/m2，ivgt d1~5,cis-platinum 80 mg/m2，ivgt d8，repeatedly every 21 days.Surgery was performed during chemotherapy.Results:32 patients completed 8 cycles of chemotherapy.25 survived up to July，2018，while 22 obtained tumor free survival.The median tumor-free survival was 40.2 months（22.5～57.3 months).Grade 3/4 adverse reactions include 6 leukopenia(16.7%),granulocytosis(22.2%)，2 anemia(2.8%) and 1 vomiting（5.6%).The MSTS 93 score for long-term survival patients was 16~30 with the average of 22.2 and excellent rate of 80.0%.SF-36 scale showed a lower score for vitality.Conclusion:Combination therapy comprising ifosfamide，cis-platinum and pegylated liposomal doxorubicin was effective and well tolerated as first-line treatment for patients with osteosarcoma，which is worthy of further research.