论文部分内容阅读
目的:探讨骨肉瘤新辅助化疗的疗效。方法:以2007年1月-2011年1月的42例骨肉瘤患者为研究对象,给予MMIA方案治疗,化疗方案为:先于术前化疗2疗程,间隔2周后根据病情选择不同方式进行手术治疗,术后继续化疗6疗程,住院治疗并随访观察6个月至4年,统计患者的生存率、肿瘤转移率、肿瘤细胞坏死率、不良反应发生率,对新辅助化疗的治疗效果、疗效判断、不良反应的预防及处理等进行分析。结果:随访期内死亡12例,生存30例,生存率为71.43%;5例发生肺转移,转移率为11.9%;肿瘤细胞坏死率>90%者12例,占28.57%;共发生不良反应34例,占80.95%,其中发生骨髓抑制7例、发生恶性呕吐11例、发生脱发15例、发生肝肾功能异常1例。结论:新辅助化疗在术前消灭肿瘤微小转移灶,控制原发灶的发展,为肿瘤的局部切除创造条件;用肿瘤化疗坏死率来判定化疗方案是否有效,指导术后化疗方案的选择;新辅助化疗可在一定程度上防止肿瘤转移,并且可以确定肿瘤对化疗的敏感性,方便调整不敏感者的化疗方案,以提高生存率;新辅助化疗可发生一定的不良反应,应注意抑制不良反应发生的药物的配合使用。
Objective: To investigate the efficacy of neoadjuvant chemotherapy for osteosarcoma. Methods: Forty-two patients with osteosarcoma from January 2007 to January 2011 were enrolled in the MMIA regimen. The chemotherapy regimen consisted of two cycles of preoperative chemotherapy and two cycles of surgery, The patients were followed up for 6 courses of chemotherapy, followed by hospitalization and follow-up for 6 months to 4 years. The survival rate, tumor metastasis rate, tumor cell necrosis rate, incidence of adverse reactions, therapeutic effect and effect on neoadjuvant chemotherapy Judgment, prevention and treatment of adverse reactions were analyzed. Results: In the follow-up period, 12 patients died and 30 patients survived, with a survival rate of 71.43%. Five patients had lung metastasis with a metastasis rate of 11.9%. Twelve patients (28.57%) had tumor necrosis rate> 90% 34 cases, accounting for 80.95%, including bone marrow suppression in 7 cases, 11 cases of malignant vomiting, hair loss occurred in 15 cases, liver and kidney dysfunction occurred in 1 case. Conclusion: neoadjuvant chemotherapy in the preoperative elimination of micrometastases, control the development of primary tumor, to create the conditions for the local excision of the tumor; the rate of tumor chemotherapy to determine the efficacy of chemotherapy to guide the choice of postoperative chemotherapy; new Adjuvant chemotherapy can prevent tumor metastasis to a certain extent, and can determine the sensitivity of the tumor to chemotherapy, to facilitate the adjustment of the chemotherapy regimen of the non-sensitive to improve the survival rate; neoadjuvant chemotherapy can occur some adverse reactions, should pay attention to inhibiting adverse reactions The use of drugs that occur.