局部性尤文肉瘤综合治疗临床分析.doc

局部性尤文肉瘤综合治疗临床分析 　　作者：马超，孙新臣 　(徐州市中心医院骨科，江苏徐州 221009;东南大学徐州肿瘤研究所放疗科，江苏徐州 221009) 　　[摘要]目的 探讨局部性尤文肉瘤的综合治疗效果。 方法 收集经综合治疗的25例尤文肉瘤患者的临床资料，采用Kaplan-Meier法进行分析、Logrank法检验，分析治疗方式和化疗周期对疗效的影响。 结果 综合治疗局部性尤文肉瘤的有效率为92%(23/25)。治疗结束后病灶完全消退组患者的1、3、5年生存率(100%、93.8%和81.3%)明显高于病灶未完全消退组(100%、75.0%和50.0%)(均P0.05)。行6个周期化疗的患者1、3、5年生存率(100%、93.8%和66.7%)高于3个周期者(88.9%、77.8%和55.6%)(均P0.01)。局部采用手术或放疗对疗效无明显影响(P0.05)。 结论 经综合治疗，局部性尤文肉瘤病灶完全消退者生存期明显延长，化疗周期的次数是影响疗效的重要因素。 　　[关键词] 局部性尤文肉瘤;放射治疗;化学治疗;手术治疗 　　Effects of combined therapy for primary nonmetastatic Ewings sarcoma 　　MA Chao，SUN Xin-chen 　　(Department of Orthopaedics，Xuzhou General Hospital，Xuzhou221009，China;Department of Radiotherapy，Affiliated Xuzhou Hospital，Southeast University，Xuzhou221009，China) 　　Abstract:Objective To evaluate the efficiency of radiotherapy and operation plus chemotherapy for primary nonmetastatic Ewings sarcoma.Methods A retrospective analysis was performed on25patients with primary non-metastatic Ewings sarcoma treated by radiotherapy or operation combined with chemotherapy.Kaplan-Meier analys-is and Logrank test were used to evaluate the survival rates，the influence from different cycles of chemotherapy and radiotherapy and operation on treatment results.Results The1-，3-，5-year survival rates were better in complete response group(100%，93.8%，81.3%，respectively)than in partial rimission(PR)and no change(NC)groups(100%，75.0%，50.0%，respectively)，with a very significant difference(P0.05).The1-，3-，5-year surviv-al rates in the6cycles group(100%，93.8%，66.7%，respectively)were better than in the3cycles group(88.9%，77.8%，55.6%，respectively)(P0.01).There was no difference between operation group and radi-ation group in1-，3-，5-year survival rates(P0.05).Conclusion The survival rate is better in complete re-mission group than in PR+NC groups.The number of chemotherapy cycles should be paid due attention. 　　Key words:primary nonmetastatic Ewings sarcoma;radiotherapy;chemotherapy;operation 　　由于尤文肉瘤