| 摘要: |
| ［摘要］目的 探讨儿童和青少年骨肉瘤患者预后影响因素．方法 回顾性分析1990年1月至2006年1月云南省第二人民医院肿瘤科收治的初发骨肉瘤患儿32例，采用COSS 96方案治疗．分析5 a生存率（overall survival，OS）和5 a无病生存率（event-free survival，EFS）与诊断时是否转移、接受手术类型、肿瘤位置、性别、组织学类型、对术前化疗组织反应以及患病年龄之间的关系．结果 所有患者5 a OS为59.4%（19/32）， EFS为46.9%（15/32）．无转移患者5 a OS显著高于有转移的患者（P＜0.05），晚期转移患者5 a OS显著高于早期转移患者（P＜0.05）．保肢术或截肢术的术后复发率无显著性差异（P＞0.05），5 a OS及5 a EFS之间无显著性差异（P＞0.05）．肿瘤原发部位在肢体近端或远端及不同组织学类型之间5 a OS 、EFS无显著差异（P＞0.05），新辅化疗敏感的患者5 a OS及5 a EFS均高于新辅化疗不敏感的患者（P＜0.05）．男、女性骨肉瘤患者5 a OS和EFS之间无显著性差异（P＞0.05），年龄≤14岁患者5 a OS 75%（12/16）、EFS 68.8%（11/16），高于年龄＞14岁的患者OS 43.8%（7/16）、EFS26.7%（4/16），P＜0.05．结论 多数患者可通过强化化疗和外科手术取得较好治疗效果．保肢手术不显著增加不良预后，但却能提供较好的的生存质量；伴有远处转移和局部复发的患者预后较差．对化疗组织反应好、年龄＜14岁的患者预后较好 |
| 关键词: ［关键词］骨肉瘤 青少年 预后 |
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| Analysis of Related Factors of Treatment and Prognosis of Osteosarcoma in Adolescence |
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LI Chong－yang
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| Abstract: |
| ［Abstract］Objective To investigate the influencing factors of prognosis of osteosarcoma in children and adolescence．Methods We retrospectively analyzed the clinical data of 32 adolescent patients with osteosarcoma admitted in our hospital from January 1990 to January 2006．All adolescent patients with osteosarcoma were given COSS 96 treatment protocol．The 5 a overall survival（OS）rate and event-free survival（EFS）rate were analyzed and their relation with metastasis，surgery types，the location of osteosarcoma，histological types，reactions to preoperative chemotherapy，gender and age of patients，were also analyzed．Results The 5 a OS and EFS was 59.4%（19/32）and 46.9%（15/32），respectively．The 5 a OS of patients without metastasis was significantly higher than that of patients with metastasis（P＜0.05），and was significantly higher in patients with late metastasis than early metastasis（P＜0.05）．There was no significant difference in the recurrence rate，5 a OS and 5 a EFS between Limb salvage surgery and amputation surgery（P＞0.05）．There was also no significant difference in 5 a OS and 5 a EFS between different location of osteosarcoma and different histological types（P＞0.05）．The 5 a OS and 5 a EFS of patients sensitive to new chemotherapy were significantly higher than those of patients insensitive to new chemotherapy（P＜0.05）．There was no significant difference in 5 a OS and 5 a EFS between patients with different gender（P＞0.05）．The 5 a OS and EFS of patients younger than 14 were significantly higher than those of patients over 14［75%（12/16）and 68.8%（11/16）vs. 43.8%（7/16）and 26.7%（4/16），P＜0.05］．Conclusions Most adolescent patients with osteosarcoma can get satisfying therapeutic effect by enhanced chemotherapy and surgery．Limb salvage surgery can improve the life quality of patients，while does not increase the risk of poor prognosis．The prognosis is poor in patients with metastasis and local recurrence， while the prognosis is good in patients with good reaction to chemotherapy and younger than 14 years |
| Key words: ［Key words］Osteosarcoma Adolescence Prognosis |