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[目的]探讨新辅助化疗联合肿瘤型人工关节置换应用于膝关节周围骨肉瘤保肢治疗的可行性。[方法]自2002年9月~2009年10月,病理活检确诊的38例膝关节周围骨肉瘤患者,采用Rosen T19方案化疗2个疗程后行人工关节置换术,术后化疗4~6个疗程。随访病例的关节功能恢复及肿瘤复发情况。[结果]37例患者获随访,随访时间18~62个月,平均49个月。术后关节活动功能恢复。ISOLS功能评定标准,术后优良率为83.8%,3例术后出现局部肿瘤复发,2例出现肺转移,2例局部感染。[结论]早期确诊,新辅助化疗联合人工关节置换术是膝关节周围骨肉瘤保肢治疗的有效措施。
[Objective] To explore the feasibility of neo-adjuvant chemotherapy combined with tumor-type artificial joint replacement in the limb salvage treatment of osteosarcoma around the knee joint. [Methods] From September 2002 to October 2009, 38 patients with osteosarcoma around the knee confirmed by pathological biopsy were treated with Rosen T19 regimen after 2 courses of chemotherapy and 4 to 6 courses of postoperative chemotherapy . Follow-up cases of joint function recovery and tumor recurrence. [Results] 37 patients were followed up for 18 to 62 months with an average of 49 months. Postoperative joint function recovery. ISOLS function evaluation criteria, postoperative excellent and good rate was 83.8%, 3 cases of local tumor recurrence after surgery, 2 cases of lung metastases, 2 cases of local infection. [Conclusion] Early diagnosis, neoadjuvant chemotherapy combined with artificial joint replacement is an effective measure of limb salvage treatment of osteosarcoma around the knee.