【摘要】 目的　分析介入性综合治疗方法治疗肢体骨肉瘤的效果。方法　对 5 5例经病理证实的肢体骨肉瘤给予 3个阶段性的治疗 :(1)经动脉局部灌注及全身化疗 2个疗程。 (2 )动脉内局部小剂量灌注同时放疗。 (3)全身化疗 6个疗程。所有病例随访 12～ 2 10个月。按完成治疗阶段分A、B、C3组 ;A组完成全部 3个阶段的治疗 ,B组完成第 1、2阶段的治疗 ,C组仅完成第 1阶段的治疗。回顾分析 3组患者的肿瘤局部控制率、累计生存率和中位生存期。结果　A、B两组总的局部控制率为86 36 % ,局部复发率为 13 6 4 %。 1、3、5年的累计生存率分别为A组 10 0 0 0 %、71 4 3%、5 3 19% ,B组 81 2 5 %、6 2 5 %、6 2 5 % ;C组 1年生存率为 2 7 2 7% ,第 2年全部死亡。 3个组的中位生存期 (含带瘤 )为 :A组 6 2 2 3个月、B组 2 0 5 7个月、C组 8 2 5个月 ,差异有非常显著性意义 (A组与B组比较 :χ2 =2 8 5 8,P <0 0 0 0 1;A组与C组比较 :χ2 =5 3 95 ,P <0 0 0 0 1;B组与C组比较 :χ2 =16 39,P <0 0 0 0 1)。结论　对肢体骨肉瘤进行介入性综合治疗能获得良好的肿瘤局部控制率及较好的远期生存率更多还原

【Abstract】 Objective To explore the long-term efficacy of interventional combined therapy for osteosarcoma of the extremities. Methods Fidty-five consecutive cases with osteosarcoma of the extremities were confirmed pathologically and treated with the “three-stage protocol”: (1)Transcatheter arterial infusion and systemic chemotherapy were performed for 2 cycles;(2)Transcatheter arterial infusion and regional radiotherapy were administered concurrently;(3)Chemotherapy was given again for 6 cycles. All the cases were followed up for 12 to 210 months and distributed into three groups according to the completion of therapeutic stages. Cases in Group A accomplished all the three therapeutic stages, cases in Group B accomplished No.1 and 2 stages, while cases in Group C accomplished only No.1 stage. The local control rates, 1-, 3-, and 5-year cumulative survival rates, and median survival time were analyzed retrospectively.Results The local control rate in Group A and B was 86.36% while the rate of recurrence was 13.64%. The 1-, 3-, 5-year cumulative survival rates were 100%, 71.43%, and 53.19% in Group A and 81.25%, 6.25%, and 6.25% in Group B. 1-year survival rate in Group C was 27.27% and other cases died in the second year. The median survival time for these data among the three groups were 62.23 months in Group A, 20.57 months in Group B, and 8.25 months in Group C, respectively. The difference of cumulative survival rate among the three groups was also significant (A-B: t=28.58, P<0.0001;, A-C: t=53.95, P<0.0001; B-C: t=16.39, P<0.0001).Conclusion The interventional combined therapy is effective in the control of regional lesion and improvement of the long-term survival.更多还原