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目的收集17家国内著名的骨肉瘤治疗科室的近5～10年资料,反映我国骨肉瘤治疗现状,阐明促成建立多中心前瞻性研究共识的重要性。方法17家医院2015例骨肉瘤患者,男性58%,女性42%;10～30岁患者占70.7%;肿瘤侵袭膝关节的病例占80%;Ⅱa期病例占1.5%～39.0%,平均10.8%;Ⅱb期病例占54%～100%,平均83%;Ⅲ期病例占2%～15%,平均8%。新辅助化疗病例64.7%～100.0%,平均77.0%,辅助化疗病例8.0%～35.3%,平均18.0%;保肢手术病例50%～100%,平均79%;截肢手术病例3%～50%,平均21%。结果随访2年以上,总生存率(OS)37.5%～77.6%(平均64.0%);总缓解率(OR)80.0%～94.5%(平均86.0%);无病生存率(DFS)34.81%～69.7%(平均56.0%);无复发生存率(RFS)32.2%～81.5%(平均60.0%)。保肢率79%;复发率0.8%～22.0%(平均9.1%);肺转移率9.0%～42.5%(平均24.8%)。结论我国治疗骨肉瘤的现状显示多学科综合治疗已成为多家治疗中心的共识。建立多中心前瞻性临床治疗研究是需要迫切解决的问题,具体包括规范的诊断、外科分期、化疗药物的选择、化疗疗效的评价、有效的复查机制。
Objective To collect the data of 17 famous osteosarcoma treatment departments in recent 5 ~ 10 years in China, and to reflect the current situation of osteosarcoma treatment in our country and to elucidate the importance of establishing consensus on multi-center prospective research. Methods A total of 17 patients with osteosarcoma from 2015 to 2015 were enrolled in this study. The prevalence of osteosarcoma was 58% in males and 42% in females, 70.7% in patients aged 10-30 years, 80% in tumors with invasion of the knee, and 1.5% -39.0% in stage Ⅱa with an average of 10.8% ; Ⅱb cases accounted for 54% to 100%, an average of 83%; Ⅲ cases accounted for 2% to 15%, an average of 8%. Neoadjuvant chemotherapy cases 64.7% to 100.0%, an average of 77.0%, adjuvant chemotherapy cases 8.0% to 35.3%, an average of 18.0%; limb salvage surgery cases 50% to 100%, an average of 79%; amputation cases 3% to 50% Average 21%. The results were followed up for more than 2 years. The overall survival rate was 37.5% -77.6% (average 64.0%), the overall response rate was 80.0% -94.5% (average 86.0%), and the disease-free survival rate was 34.81% 69.7% (mean 56.0%), and non-recurrence (RFS) 32.2% -81.5% (average 60.0%). Limb salvage rate of 79%; recurrence rate of 0.8% to 22.0% (average 9.1%); lung metastasis rate of 9.0% to 42.5% (average 24.8%). Conclusion The status of osteosarcoma treatment in our country shows that multidisciplinary comprehensive treatment has become the consensus of many treatment centers. The establishment of multi-center prospective clinical treatment research is an urgent problem to be solved, including the standard diagnosis, surgical staging, the choice of chemotherapy drugs, the evaluation of chemotherapy efficacy, effective review mechanism.