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目的观察骨恶性纤维组织细胞瘤(MFH-B)采用皮下埋植式动脉化疗泵的治疗效果。方法2004年4月～2008年5月共治疗5例骨恶性纤维组织细胞瘤患者,发病部位髂骨1例,股骨3例,胫骨1例;术前经皮下埋植式给药装置(化疗泵)行表阿霉素、顺铂导向性灌注3～5次,联合咖啡因或去甲斑蝥素治疗,化疗后通过临床及影像学观察有明显改变后进行保肢手术。结果4例患者化疗后疼痛完全缓解,1例明显缓解,且病变均有明显影像学改变,术后病理显示5例均有中重度的化疗反应,平均随访26个月,肺转移1例死亡,其余4例无复发和转移。结论皮下埋植式动脉化疗治疗MFH-B具有良好效果,化疗后的影像学改变显著,化疗后的肿瘤细胞广泛坏死,病理改变明显。
Objective To observe the therapeutic effect of subcutaneous implantable arterial chemotherapy pump on malignant fibrous histiocytoma (MFH-B). Methods From April 2004 to May 2008, a total of 5 cases of malignant fibrous histiocytoma were treated, including 1 case of ilium, 3 cases of femur and 1 case of tibia. Preoperative percutaneous implant device (chemotherapy pump ) Epirubicin, cisplatin-guided perfusion 3 to 5 times, combined with caffeine or norcantharidin treatment, after chemotherapy and clinically significant changes in imaging observed limb salvage surgery. Results The pain of 4 patients was completely relieved after chemotherapy, and 1 patient was relieved obviously. The pathological changes of the 4 patients showed significant radiological changes. The pathological findings showed that all 5 patients had moderate or severe chemotherapy response. The patients were followed up for an average of 26 months. One patient died of lung metastasis, The remaining 4 cases without recurrence and metastasis. Conclusion Subcutaneous implantable arterial chemotherapy for MFH-B has a good effect. The imaging changes after chemotherapy are significant. The tumor cells after chemotherapy are extensively necrotic and the pathological changes are obvious.