新辅助化疗联合外科保肢手术治疗骨肉瘤远期生存分析

目的探讨骨肉瘤经新辅助化疗联合外科保肢手术的临床疗效。方法采取前瞻性研究方法,将骨肉瘤患者68例根据治疗方式分为观察组(保肢手术+新辅助化疗)38例,对照组(保肢手术+术后常规化疗)30例。采取Kaplan-Meier法及Log-rank检验,估计各组生存时间的生存率以及中位生存时间,比较两组生存时间的差异。结果观察组的中位生存期为71个月,3年、5年生存率分别为73.7%(28/38)、65.8%(25/38);对照组中位生存期为59个月,3年、5年生存率分别为53.3%(16/30)、46.7%(14/30),观察组的生存率明显优于对照组,差异有统计学意义(χ2=19.403,P=0.000)。结论新辅助化疗联合外科保肢手术是治疗骨肉瘤安全、有效的方法,术前积极有效化疗是改善预后的重要环节。

Neoadjuvant chemotherapy combined with limb salvage surgery for treatment of osteosarcoma long - term survival analysis

Objective To evaluate the treatment efficacy of neoadjuvant chemotherapy combined with limb salvage surgery for treatment of osteosarcoma. Methods A prospective analysis was performed in 68 cases of osteosarcoma in our hospital. According to different treatments,these patients were divided into the different group. 38 patients receiving neoadjuvant chemotherapy combined with limb salvage surgery（ observer group）,and others receiving chemotherapy treatment after limb salvage surgery（ control group）. The survival rate was analyzed by Kaplan-Meier method and Log-Rank test. Results The median survival of 68 patients was 62 months,Median survival of observer group was 71 months. That of control group was 59 months; 3-year,5-year survival rates of observer group were 73. 7%,65. 8% respectively. Those of control group were53. 3%,46. 7% respectively with significant difference（ χ2= 19. 403,P = 0. 000）. Conclusion The neoadjuvant chemotherapy combined with limb salvage surgery is an effective treatment method for osteosarcoma. An effective preoperative chemotherapy can help limb salvage surgery successful.