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目的探讨术中放疗与外科手术联合治疗不同部位骨恶性肿瘤的相关技术及临床疗效。方法回顾性研究2005年7月至2010年7月收治的15例骨恶性肿瘤患者。15例患者均接受术中放疗及手术治疗。手术及术中照射均顺利,无麻醉及手术意外发生。结果 15例患者均接受随诊,时间从6~80个月不等,1例骨肉瘤患者2年后出现肺转移,行放化疗,肺转移2年后死亡,1例于术后第3年复发后行截肢术,现仍存活,无复发及转移。1例股骨远端软骨肿瘤患者术后3年假体松动,行关节返修,术后功能好,现复查未见复发及转移。余12例患者肢体功能正常,日常生活不受影响,保肢成功率86.6%。结论术中放疗与外科手术联合治疗可以在有效的切除病灶基础上,提高局控率,降低肿瘤复发率,延长患者生命,保住肢体,并在最大程度上保留关节功能,提高患者的生存质量。
Objective To investigate the related techniques and clinical effects of intraoperative radiotherapy and surgical treatment of malignant tumors of different sites. Methods A retrospective study of 15 patients with malignant bone tumors from July 2005 to July 2010 was performed. All 15 patients received intraoperative radiotherapy and surgical treatment. Surgery and intraoperative irradiation were smooth, no anesthesia and surgical accidents. Results Fifteen patients were followed up from 6 to 80 months. One patient with osteosarcoma developed pulmonary metastasis after 2 years, and received chemotherapy and radiotherapy after 2 years of lung metastasis. One patient died after 3 years Amputation after recurrence is still alive, no recurrence and metastasis. One patient with distal femoral cartilage tumor had a loose prosthesis 3 years postoperatively and the joint was repaired. The postoperative function was good. No recurrence and metastasis were found after the procedure. The remaining 12 patients with normal limb function, daily life is not affected, limb salvage success rate of 86.6%. Conclusions Intraoperative radiotherapy combined with surgical treatment can increase the rate of local control, reduce the recurrence rate, prolong the life of the patient, keep the limbs, and retain the joint function to the maximum extent and improve the quality of life of the patients on the basis of effective excision lesions.