大剂量甲氨蝶呤、顺铂联合阿霉素新辅助化疗骨肉瘤的近期疗效分析

郑家雷; 方向; 汪子书

doi:10.13898/j.cnki.issn.1000-2200.2015.12.005

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大剂量甲氨蝶呤、顺铂联合阿霉素新辅助化疗骨肉瘤的近期疗效分析

郑家雷 , 方向 , 汪子书

文章导航 > 蚌埠医学院学报 > 2015, 40 > 12: (1631-1634)

引用本文:

Citation:

大剂量甲氨蝶呤、顺铂联合阿霉素新辅助化疗骨肉瘤的近期疗效分析

1. 蚌埠医学院第一附属医院肿瘤内科, 安徽蚌埠 233004;
2. 安徽省立医院老年医学科, 安徽合肥 230001

作者简介: 郑家雷(1983-),男,住院医师.

中图分类号: R738.1

The short-term effect of the large dose of methotrexate,cisplatin combined with adriamycin in the chemotherapy of osteosarcoma

1. Department of Internal Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004;
2. Department of Geriatric Medicine, Anhui Provincial Hospital, Hefei Anhui 230001, China
CLC number: R738.1

摘要: 目的:观察大剂量甲氨蝶呤(MTX)、顺铂(PDD)联合阿霉素(ADR)新辅助化疗骨肉瘤的近期疗效及不良反应.方法:选择经过组织病理学及影像学诊断、有客观评价指标、初治的ⅡB期肢体骨肉瘤患者30例作为研究对象,化疗方案均为大剂量MTX、PDD 联合ADR,21 d为 1周期,3~4个周期复查病变部位MRI及平片后行人工关节置换术或截肢术,根据术后骨肉瘤的病理学检查肿瘤组织坏死率及保肢成功率评价疗效.结果:术后骨肉瘤病理学检查肿瘤组织坏死率>90%的患者占86.7%,保肢成功为53.0%.不良反应中恶心呕吐、脱发和中性粒细胞减少发生率均为100.0%(30/30),血红蛋白降低率为86.7%,白细胞升高率16.7%,口腔肠道黏膜炎发生率26.7%,肝功能损害率13.3%.结论:大剂量MTX、PDD联合ADR新辅助化疗骨肉瘤患者术后病理学检查肿瘤组织坏死率高,保肢成功率高,近期疗效肯定,不良反应可耐受,值得推广使用.
- 骨肉瘤 /
- 甲氨蝶呤 /
- 顺铂 /
- 阿霉素
Abstract: Objective:To investigate the short-term effects and adverse reactions of the large dose of methotrexate(MTX),cisplatin(PPD) combined with adriamycin(ADR) in the chemotherapy of osteosarcoma.Methods:Thirty extremity osteosarcoma patients(ⅡB phase) diagnosed by histopathology and imaging were investigated.All patients were treated with the high dose of MTX,PDD combined with ADR,21 days for a cycle.The artificial joint replacement or amputation were implemented according to the MRI and plain film of lesions after 3 to 4 cycles of treatment.The curative effects were evaluated by the salvage success rate and tumor tissue necrosis rate according to the postoperative osteosarcoma pathological examination.Results:The tumor necrosis in more than 90% patients was identified by the result of postoperative pathological examination of osteosarcoma,the rates of tumor necrosis and salvage success were 86.7% and 53.0%,respectively.All the incidences of nausea and vomiting,hair loss and neutrophilopenia were 100.0%.The rates of hemoglobin reducing and white blood cell increasing were 86.7% and 16.7%,respectively.The incidences of oral and intestinal mucositis,and liver dysfunction were 26.7% and 13.3%,respectively.Conclusions:The treatment of osteosarcoma with high dose MTX,PDD combined with ADR is high tumor tissue necrosis and limb salvage rate,good curative effect and tolerable adverse reactions,which is worthy of clinical use.
- osteosarcoma /
- methotrexate /
- cisplatin /
- adriamycin

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大剂量甲氨蝶呤、顺铂联合阿霉素新辅助化疗骨肉瘤的近期疗效分析

作者简介: 郑家雷(1983-),男,住院医师.

1. 蚌埠医学院第一附属医院肿瘤内科, 安徽蚌埠 233004;
2. 安徽省立医院老年医学科, 安徽合肥 230001

收稿日期: 2015-05-01

关键词:

骨肉瘤 /
甲氨蝶呤 /
顺铂 /
阿霉素

摘要: 目的:观察大剂量甲氨蝶呤(MTX)、顺铂(PDD)联合阿霉素(ADR)新辅助化疗骨肉瘤的近期疗效及不良反应.方法:选择经过组织病理学及影像学诊断、有客观评价指标、初治的ⅡB期肢体骨肉瘤患者30例作为研究对象,化疗方案均为大剂量MTX、PDD 联合ADR,21 d为 1周期,3~4个周期复查病变部位MRI及平片后行人工关节置换术或截肢术,根据术后骨肉瘤的病理学检查肿瘤组织坏死率及保肢成功率评价疗效.结果:术后骨肉瘤病理学检查肿瘤组织坏死率>90%的患者占86.7%,保肢成功为53.0%.不良反应中恶心呕吐、脱发和中性粒细胞减少发生率均为100.0%(30/30),血红蛋白降低率为86.7%,白细胞升高率16.7%,口腔肠道黏膜炎发生率26.7%,肝功能损害率13.3%.结论:大剂量MTX、PDD联合ADR新辅助化疗骨肉瘤患者术后病理学检查肿瘤组织坏死率高,保肢成功率高,近期疗效肯定,不良反应可耐受,值得推广使用.

English Abstract

The short-term effect of the large dose of methotrexate,cisplatin combined with adriamycin in the chemotherapy of osteosarcoma

1. Department of Internal Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004;
2. Department of Geriatric Medicine, Anhui Provincial Hospital, Hefei Anhui 230001, China

Received Date: 2015-05-01

Abstract: Objective:To investigate the short-term effects and adverse reactions of the large dose of methotrexate(MTX),cisplatin(PPD) combined with adriamycin(ADR) in the chemotherapy of osteosarcoma.Methods:Thirty extremity osteosarcoma patients(ⅡB phase) diagnosed by histopathology and imaging were investigated.All patients were treated with the high dose of MTX,PDD combined with ADR,21 days for a cycle.The artificial joint replacement or amputation were implemented according to the MRI and plain film of lesions after 3 to 4 cycles of treatment.The curative effects were evaluated by the salvage success rate and tumor tissue necrosis rate according to the postoperative osteosarcoma pathological examination.Results:The tumor necrosis in more than 90% patients was identified by the result of postoperative pathological examination of osteosarcoma,the rates of tumor necrosis and salvage success were 86.7% and 53.0%,respectively.All the incidences of nausea and vomiting,hair loss and neutrophilopenia were 100.0%.The rates of hemoglobin reducing and white blood cell increasing were 86.7% and 16.7%,respectively.The incidences of oral and intestinal mucositis,and liver dysfunction were 26.7% and 13.3%,respectively.Conclusions:The treatment of osteosarcoma with high dose MTX,PDD combined with ADR is high tumor tissue necrosis and limb salvage rate,good curative effect and tolerable adverse reactions,which is worthy of clinical use.