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目的 :探讨单纯大剂量新型重组肿瘤坏死因子对骨肉瘤的抗肿瘤效果 ,以及其对人体的毒副作用。方法 :5例经过病理确诊的下肢骨肉瘤患者 ,采用股动静脉插管 ,体外循环隔离加温灌注 ,从氧合器加入新型重组肿瘤坏死因子 5 0 0万单位至70 0万单位 ,灌注区肿瘤组织内温度保持在 41~ 42℃之间 ,持续 6 0 min。灌注后 2~ 3周行肿瘤段骨切除 ,人工膝关节置换术。结果 :新型肿瘤坏死因子灌注后 ,5例患者疼痛明显减轻 ,肿瘤缩小 3.5~ 5 .0 cm灌注区有不同程度的发热和灌注区域的炎症样红肿 ,1例出现寒战 ,2例发生低血压 ,无肾衰。组织学发现肿瘤坏死率达 88%~ 96 %。随访 3个月至 2 0个月 ,平均 6个月。 4例存活 ,1例术后 3个月肺转移死亡 ,无 1例发生局部复发。结论 :单纯大剂量新型重组肿瘤坏死因子具有较好的抗肿瘤效果及明显的镇痛作用。有一定毒性
Objective: To investigate the antitumor effect of high-dose recombinant recombinant tumor necrosis factor on osteosarcoma and its toxic effects on human. Methods: Five cases of lower extremity osteosarcoma diagnosed by pathology were treated with femoral arteriovenous cannulation and cardiopulmonary bypass. The new type of recombinant tumor necrosis factor 500 million was added into the oxygenator to 70 million units. The perfusion area Tumor tissue temperature maintained at between 41 ~ 42 ℃, sustained 60 min. Tumor resection 2 to 3 weeks after perfusion, artificial knee replacement. Results: After the new type of tumor necrosis factor was infused, the pain of 5 patients was significantly reduced. The tumor size was 3.5 ~ 5 cm. There were different degrees of fever and inflamed inflamed area in the perfusion area, 1 case of chills, 2 cases of hypotension, No renal failure. Histology found tumor necrosis rate of 88% to 96%. Followed up for 3 months to 20 months, an average of 6 months. Four patients survived, and one patient died of pulmonary metastasis 3 months after operation. No local recurrence occurred in 1 patient. Conclusion: The simple and high-dose recombinant tumor necrosis factor has good anti-tumor effect and obvious analgesic effect. A certain toxicity