论文部分内容阅读
目的探讨骨与软组织恶性肿瘤影像学诊断和介入综合治疗方法选择、疗效和预后。方法58例经骨穿活检或手术病理证实的骨与软组织恶性肿瘤,全部经肿瘤局部供血动脉灌注化疗或超选择肿瘤血管栓塞,随访4个月至12年,局部灌注化疗19例,超选择肿瘤血管术前栓塞8例,灌注化疗加超选择肿瘤血管栓塞31例;共行介入治疗78疗次。结果影像学诊断与病理结果符合率为70.73%;介入治疗后近期临床改善80.65%,保肢率为73%;局部灌注加栓塞在疗效上优于局部单纯化疗灌注(P<0.05)。结合手术瘤骨切除、瘤骨灭活或截肢以及免疫增强等综合治疗,2年生存率73.2%。结论骨与软组织恶性肿瘤的早期诊断、早期局部介入治疗结合手术等综合治疗对增加保肢率,改善生活质量,提高5年生存率具有重要意义,是值得探索和完善的治疗方法。
Objective To explore the imaging diagnosis and interventional treatment of bone and soft tissue malignant tumors, the selection, curative effect and prognosis. Methods Fifty-eight patients with bone and soft tissue malignant tumors confirmed by biopsy or pathological examination were all treated with local arterial infusion chemotherapy or superselective tumor angioplasty. The patients were followed up for 4 months to 12 years. Local perfusion chemotherapy was performed in 19 patients. Superselective tumors Preoperative embolization in 8 cases, perfusion chemotherapy and superselective tumor embolization in 31 cases; a total of 78 interventions. Results The coincidence rate of imaging diagnosis and pathological results was 70.73%. The clinical improvement 80.65% and salvage rate 73% after interventional therapy. The local perfusion and embolization were better than the local chemotherapy alone perfusion (P <0.05). Combined with surgical tumor resection, tumor inactivation or amputation and immune enhancement and other comprehensive treatment, 2-year survival rate of 73.2%. Conclusions The early diagnosis of bone and soft tissue malignant tumor, early local intervention combined with surgery and other comprehensive treatment is of great significance to increase the limb salvage rate, improve the quality of life and increase the 5-year survival rate, which is worth to explore and improve the treatment.