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目的:本研究旨在探讨含吡柔比星(pirarubicin,THP)方案治疗骨肉瘤肺转移患者的疗效,并对心脏功能等相关不良反应进行评估。方法:32例骨肉瘤肺转移患者接受THP(50 mg/m2,d 1)联合顺铂(cisplatin,DDP)(80 mg/m2,分成2~3d)或异环磷酰胺(ifosfamide,IFO)(8 g/m2,分成4 d)治疗,评价近期疗效。应用心脏超声检测患者THP治疗前后左室射血分数和E/A值等心脏功能指标。结果:含THP方案治疗骨肉瘤肺转移患者中位总生存时间为(31.00±7.98)个月,无疾病进展时间为(13.00±2.46)个月,客观缓解率为46.88%,部分缓解率为40.63%。含THP方案化疗的不良反应主要为胃肠反应和骨髓抑制;THP不同累积剂量组左室射血分数差异无统计学意义,THP累积剂量较大组的E/A值较化疗前明显降低(P<0.05)。结论:含THP方案治疗骨肉瘤肺转移患者是较为有效和安全的,可以作为挽救性化疗选择方案。二维彩色多普勒超声技术可作为评价蒽环类药物早期心脏毒性的检测手段之一。
OBJECTIVE: To investigate the efficacy of pirarubicin (THP) regimen in the treatment of patients with lung metastases of osteosarcoma and evaluate the adverse effects of cardiac function. METHODS: Twenty-two patients with osteosarcoma lung metastasis underwent THP (50 mg / m2, d1) combined with cisplatin (DDP) (80 mg / m2 divided into 2 to 3d) or ifosfamide (IFO) 8 g / m2, divided into 4 d) treatment, evaluation of the recent efficacy. Application of cardiac ultrasound in patients with THP before and after treatment of left ventricular ejection fraction and E / A and other cardiac function indicators. Results: The median overall survival time was (31.00 ± 7.98) months with THP regimen in patients with osteosarcoma lung metastasis, and no disease progression time was (13.00 ± 2.46) months. The objective response rate was 46.88% and the partial response rate was 40.63 %. Adverse reactions induced by chemotherapy with THP were mainly gastrointestinal reactions and myelosuppression. There was no significant difference in left ventricular ejection fraction (LVEF) between different cumulative doses of THP, and the E / A of THP with larger cumulative doses was significantly lower than that before chemotherapy (P <0.05). Conclusion: THP regimen is an effective and safe treatment for patients with lung metastasis of osteosarcoma and can be used as a salvage chemotherapy option. Two-dimensional color Doppler ultrasound technology can be used as a measure of anthracycline early cardiotoxicity detection means.