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目的比较儿童青少年期骨肉瘤两种治疗方法的疗效。方法选取本院骨肉瘤患者21例。男14例,女7例;平均年龄14.5岁。发生部位:肱骨上端、股骨近端、胫骨上端各1例,股骨干5例,股骨远端13例。骨肉瘤患者分为综合化疗保肢组(A组,13例)和单纯截肢或不规则化疗截肢组(B组,8例)。评价两组患者复发转移率、3 a生存率及A组患者术后肢体功能情况。结果 21例均获随访。A组患儿复发或转移率为15.4%(2/13例),低于B组患儿62.5%(5/8例),差异有统计学意义(P<0.05)。A组3 a生存率为69.2%,B组为25.0%,两组比较差异有统计学意义(P<0.05)。采用Enneking肢体肌肉骨骼系统肿瘤外科治疗重建术后功能评价系统,A组术后患肢功能优3例,良5例,可3例,差2例,优良率为61.5%。结论新辅助化疗联合保肢手术能降低复发转移率,提高患儿的生存率,不但可以保留肢体,且保留的肢体具有良好功能,是治疗儿童青少年期骨肉瘤的理想方法。
Objective To compare the efficacy of two treatment methods for adolescent osteosarcoma in children. Methods Select 21 cases of osteosarcoma in our hospital. There were 14 males and 7 females with an average age of 14.5 years. Occurred parts: the upper humerus, the proximal femur, the upper tibia in 1 case, 5 cases of femoral shaft, distal femur in 13 cases. Osteosarcoma patients were divided into three groups: group A (13 cases) and group B (group B: 8 cases). The recurrence and metastasis rate, 3-year survival rate and the postoperative functional status of the two groups were evaluated. Results 21 cases were followed up. The recurrence or metastasis rate in group A was 15.4% (2/13 cases), which was lower than that in group B (62.5%) (5/8 cases). The difference was statistically significant (P <0.05). The 3-year survival rate was 69.2% in group A and 25.0% in group B, with significant difference between the two groups (P <0.05). With Enneking limb musculoskeletal system tumor surgical reconstruction and postoperative functional evaluation system, group A postoperative limb function excellent in 3 cases, good in 5 cases, fair in 3 cases and poor in 2 cases, the excellent and good rate was 61.5%. Conclusion Neoadjuvant chemotherapy combined limb salvage surgery can reduce the recurrence and metastasis rate and improve the survival rate of children, not only can retain the limbs, and retain the limbs with good function, is an ideal method for the treatment of adolescent osteosarcoma.