肢体恶性骨肿瘤局部切除联合放疗的保肢疗效观察
恶性骨肿瘤,,恶性骨肿瘤；术中放疗；术后放疗；保肢,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 对肢体恶性骨肿瘤局部切除联合术中和术后放疗，观察保肢疗效。方法 1998年1月起，我院对16例肢体恶性骨肿瘤(按病理骨肉瘤6例，软骨肉瘤3例，骨巨细胞瘤6例，纤维肉瘤1例；按部位股骨5例，胫骨5例，肱骨3例，腓骨2例，桡骨1例)行骨肿瘤局部切除术及术中放疗加植骨。术中放疗采用6～12MeV电子线，在直视下一次性照射瘤灶区15～20Gy。术后补充外照射45～50Gy/5周及化疗。患者进行随访，观察保肢疗效。结果 平均随访3年以上，局部控制率75%(12/16)，保肢成功率68.75%(11/16)。结论 骨肿瘤局部切除术中放疗，补充术后放疗、化疗，有较好的局部控制率，达到保肢目的。【关键词】 恶性骨肿瘤；术中放疗；术后放疗；保肢
Limb sparing operation combined intraoperative and postoperative radiotherapy for bone malignant tumor of extremities
PENG Li-hua,SUN Yi,ZHANG Qing,et al.Department of Radiotherapy, The Sixth Peoples Hospital of Shanghai, Shanghai Jiaotong University, Shanghai 200233, China
【Abstract】 Objective To discuss the feasibility of intraoperative radiotherapy and postoperative radiotherapy in limb sparing operation for treatment of bone malignant tumor of extremities.Methods From January 1998, sixteen patients suffed from osteosarcoma(6 cases), chondrosarcoma(3 cases), gaint cell tumor(6 cases) and fibrosarcoma(1 case) arising from femur(5 cases), tibia(5 cases), humerus(3 cases), fibula(2 cases), radius(1 case). Allograft transplantation was used in reconstruction for the defect after tumor resection while the tumor was irradiated 15～20Gy with 6～12MeV electron ray during operation. After operation, all patients were accepted postoperative radiotherapy (45～50Gy/5weeks) and chemotherapy with curative effect. Results All patients had more than 3 years follow-up. The rate of local control was 75% (12/16) and the rate of limb sparing was 68.75% (11/16). Conclusion The combination of tumor resection and intraoperative and postoperative radiotherapy and chemotherapy in limb sparing operation is a very effective and well-tolerated regimen for bone malignant tumor of extremities. ......
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