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目的探讨原发性骨肉瘤的治疗及预后。方法回顾性分析2004年1月至2011年6月收治的48例原发性骨肉瘤患者的临床资料,均为保肢手术治疗的患者,其中行MMIA(大剂量甲氨蝶呤、异环磷酰胺和阿霉素)术前化疗的21例设为A组,未行术前化疗的27例设为B组,比较两组患者的预后。结果 A组患者化疗后骨肉瘤(OS 732)及其耐药细胞(R OS 732)活性明显改善,与化疗前比较差异均有统计学意义(P<0.05);A组患者的局部复发率为4.8%、明显低于B组的33.3%,组间差异有统计学意义(P<0.05);A组患者的18个月生存率为81.0%,明显高于B组患者的51.9%,组间差异有统计学意义(P<0.05)。结论原发性骨肉瘤保肢手术前行MMIA化疗可以明显改善患者的骨肉瘤及其耐药细胞活性,降低局部复发率、提高生存率,获得更佳的临床预后。
Objective To investigate the treatment and prognosis of primary osteosarcoma. Methods The clinical data of 48 patients with primary osteosarcoma who were treated from January 2004 to June 2011 were retrospectively analyzed. All patients undergoing salvage operation were treated with MMIA (high dose methotrexate, Amide and doxorubicin) 21 cases of preoperative chemotherapy as A group, 27 cases were not preoperative chemotherapy for the B group, compared the prognosis of two groups of patients. Results The activity of osteosarcoma (OS 732) and its drug-resistant cell (R OS 732) in group A was significantly improved after chemotherapy, which was significantly different from that before chemotherapy (P <0.05). The local recurrence rate in group A was (P <0.05). The 18-month survival rate in group A was 81.0%, which was significantly higher than that in group B (51.9%). There was no significant difference between the two groups The difference was statistically significant (P <0.05). Conclusions MMIA chemotherapy can significantly improve the osteosarcoma and drug-resistant cell activity, reduce the local recurrence rate, improve the survival rate and achieve a better clinical prognosis.