含洛铂动脉灌注化疗联合保肢手术治疗肢体骨肉瘤的近远期临床疗效及其对Ras、ErbB3和PTEN含量的影响

目的探讨含洛铂的新辅助动脉灌注化疗联合保肢手术治疗肢体骨肉瘤的近远期临床疗效及其对Ras、Erb B3和PTEN含量的影响。方法选取2007年2月至2013年7月我院骨科收治的78例肢体骨肉瘤患者为研究对象,按照治疗方式的不同随机分为观察组和对照组,每组39例。观察组采用洛铂的动脉灌注化疗联合保肢手术治疗,而对照组患者采用传统保肢手术联合术后化疗,分别比较两组患者的近远期疗效及Ras、Erb B3、PTEN含量的变化。结果观察组的总体有效率高于对照组(92.31%vs.73.36%,χ~2=4.523,P=0.033),肢体Enneking评分值和优良率高于对照组(t=4.088,P=0.012;χ~2=4.588,P=0.032);观察组、对照组的不良反应发生率分别为35.90%、28.21%,两组比较差异无统计学意义(χ~2=0.530,P=0.467)。随访结果显示,观察组1年、2年生存率分别为94.87%、87.18%,对照组为82.05%、58.97%,两组患者1年生存率比较差异无统计学意义(P>0.05),但观察组2年生存率高于对照组(χ~2=7.885,P=0.005);观察组的总生存时间较对照组延长(χ~2=4.400,P=0.036),局部复发率与转移率低于对照组(χ~2=5.186,P=0.023)。治疗后,观察组血清Ras、Erb B3改变程度优于对照组(P<0.05),两组PTEN含量比较差异无统计学意义(P>0.05)。结论含洛铂的新辅助动脉灌注化疗联合保肢手术对骨肉瘤具有良好的近远期疗效,并且明显改善血清肿瘤相关基因Ras和Erb B3的水平。

Curative effect of neoadjuvant arterial infusion chemotherapy containing lobaplatin combined with limb salvage operation in the treatment of osteosarcoma and its in-fluence on the levels of Ras,ErbB3 and PTEN

Objective To investigate the curative effect of neoadjuvant arterial infusion chemotherapy contai-ning lobaplatin combined with limb salvage operation in the treatment of osteosarcoma and its influence on the levels of Ras,ErbB3 and PTEN. Methods Seventy-eight cases of osteosarcoma from February 2007 to July 2013 in our hospital were randomly divided into observation group and control group according to the different treatment measures,39 cases in each group. Patients in observation group were treated by lobaplatin neoadjuvant arterial infusion chemotherapy com-bined with limb salvage operation,while patients in control group were treated with traditional salvage operation and postoperative chemotherapy. Short and long term curative effects and the levels of Ras,ErbB3 and PTEN were com-pared. Results The total effective rate of observation group was higher than that of control group ( 92. 31% vs. 73. 36%,χ2 =4. 523,P=0. 033)with higher Enneking score(t=4. 088,P=0. 012)and excellent rate(χ2 =4. 588, P=0. 032). The incidence of adverse reaction of observation group and control group were 35. 90% and 28. 21% re-spectively,and there was no significant difference between the two groups(χ2 =0. 530,P=0. 467). The follow-up re-sults showed that there was no significant difference in 1 year survival rate between observation group and control group (94. 87% vs. 82. 05%,P﹥0. 05),while the 2-year survival rate of observation group was higher than that of control group(87. 18% vs. 58. 97%,χ2 =7. 885,P=0. 005). The overall survival time of observation group was longer than that of control group(χ2 =4. 400,P =0. 036 ),with lower local recurrence and metastasis rate(χ2 =5. 186,P =0. 023). The serum Ras and ErbB3 levels in observation group were improved more significantly than those of control group(P﹤0. 05),while no significant difference was observed in PTEN between the two groups(P﹥0. 05). Conclu-sion Lobaplatin neoadjuvant arterial chemotherapy combined with limb salvage operation has good long-term and short-term effects on osteosarcoma,and it can significantly improve the level of serum Ras and ErbB3.