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目的探讨皮下埋置式(subcutaneous implantable delivery system,SIDS)动脉化疗应用于股骨远端恶性肿瘤(distal femur neoplasms,DFN)的临床效果。方法自2002年3月至2006年12月共系统治疗DFN39例,其中骨肉瘤33例、恶性纤维组织细胞瘤6例,所有患者均采用以SIDS动脉介入化疗为策略的新辅助化疗,化疗后绝大数患者采取定制人工假体置换。结果随访24~57个月,骨痛缓解率97.4%,骨病变的影像学较显著改变者占74.4%,病理中重度以上化疗反应占87.2%。31例患者无局部复发或远处转移,3例局部复发,2例肺转移患者带瘤生存,3例因肺转移死亡。结论采用股动脉介导的SIDS新辅助化疗对DFN具有良好临床疗效,结合人工假体置换是DFN的有效治疗策略。
Objective To investigate the clinical effect of subcutaneous implantable delivery system (SIDS) arterial chemotherapy on distal femur neoplasms (DFN). Methods From March 2002 to December 2006, a total of 39 cases of DFN were treated with DFN, including 33 cases of osteosarcoma and 6 cases of malignant fibrous histiocytoma. All patients underwent neoadjuvant chemotherapy with SIDS arterial chemotherapy. Large number of patients to take custom artificial prosthesis replacement. Results The follow-up ranged from 24 months to 57 months. The pain relief rate was 97.4%. The lesions of bone lesions were significantly changed 74.4%. The moderate and severe pathological changes accounted for 87.2%. There were no local recurrence or distant metastasis in 31 patients, local recurrence in 3 patients, tumor survival in 2 patients with lung metastasis and death in 3 patients due to pulmonary metastasis. Conclusion Femoral artery-mediated neoadjuvant chemotherapy with SIDS has a good clinical effect on DFN. Combined with artificial prosthesis replacement is an effective treatment strategy for DFN.