儿童骨肉瘤单中心诊治分析:附25例报告

目的制定本中心儿童骨肉瘤治疗方案,对该方案进行疗效分析。方法前瞻性制定包括病理分型、临床分期、分组、化疗、手术的整体性诊断治疗方案,方案适用对象为1998年10月-2009年12月期间经病理检查确诊为骨肉瘤的连续初治病例,共25例,按方案根据不同个体对治疗反应的差异在不同治疗阶段手术,按影像学和病理学对治疗反应的评估,给予不同强度的化疗。分析本组患儿的治疗依从性和远期预后。结果全组25例,放弃治疗1例,接受手术10例,完成术前化疗2～4个疗程后拒绝手术14例。完成手术及化疗计划8例,其中4例无事件生存>32个月;2例手术者在术后化疗中复发。未手术者14例中3例在2～36个月内重新进展,12例失访。结论儿童骨肉瘤治疗依从性差,局部病灶根治性手术率低是影响预后的最重要因素。

A single center experience on treatment of osteosarcoma in children: 25 cases report

Objective To analyze the therapeutic effects of the protocol in childhood osteosaicoma.Methods The protocol OS-99 was designed based on imaging and pathology evaluation.Twenty five newly diagnosed patients from Oct.1998 to Dec.2009 were continually enrolled and treated with different intensity therapy depending on their pathology evaluation.Surgery was given after variably chemo-courses depending on the response to chemotherapy.The treatment compliance and long-term outcome were analyzed.Results Twenty five patients were enrolled,and one of them gave up after diagnosis.Ten of them received both surgery and chemotherapy.Fourteen refused surgery after pre-surgery chemotherapy.During following up,two patients in the surgery group progressed before finishing the chemotherapy;four relapsed and four survived with disease-free time longer than 32 months(ranged from 32 to 172 months).Conclusions The treatment compliance is poor in childhood osteosarcoma.Lower radical operation rate is the main factor leading to poor prognosis.