骨与软组织恶性肿瘤的介入综合治疗——影像学诊断与影响疗效因素研究.doc

骨与软组织恶性肿瘤的介入综合治疗——影像学诊断与影响疗效因素研究 ?88?中国介入影像与治疗学2006年第3鲞箜塑』!!!!!墨堕!垒竺!!!!! Studyofimagingdiagnosisandinterventionalsynthetictherapy forboneandSOfttissuesarcoma MAHe-ping”.ZhangXue-jun.,ChaoLu—meng,ZHENYah—li.,SULi.,LVLong, LIUJiang,WURui—xing,LILin—qi,LIUJian-feng,LUMin (1.CenterofClinicalInterventionalRadiology,2.DepartmentofOrthopedics,InnerMongoliaAutonomousRegion’sHospital, Hohehot010017,China;3.DepartmentofPreventiveMedicine,InnerMongoliaMedicalCollege,Hohehot010059,China) ABSTRACT0bjectiveTostudytheradiographicfindings.effectandprognosisofinterventionaltherapy(IVT)forbone andsofttissuesarcoma.MethodsFifty-eightpatientsconfirmedbypathologicalexaminationorbonebiopsypunctune, whichtreatedbylocaltransarterialinfusion(TADchemotherapyor/andtransarterialembolization(TAE)beforesurgery werefollowedupfrom4monthsto12years.Therewere19patientsusingsimplelocalinfusionand8patientsperforming superselectiveembolizedtumorvesselsbeforesurgeryand31patientswerebothdone.ResultsThepercentageofagree— mentbetweenimagingdiagnosisandpathologicalresultwas70.73,therateofclinicalimprovementafterIVTinshort- termwas8O.65,limbsalvageratewas73,theeffectoflocalinfusionplusembolizationsurpassedsimplechemothera— pyinfusion(Plt;0.05).thesurvivalratewas73.20Aduring2years.ConclusionThesynthetictherapyofIVTcombine withsurgeryforboneandsofttissuesarcomawasobviouslyimproved,thisimprovementhasfavorablevalueinenhance— mentthelimbsalvagerate.thequalityoflifeandthesurvivalratein5years. KEYWORDSBoneneoplasms;Softtissuesarcoma;Limbsalvage;Radiology,interventional;Chemotherapy;Emboliza— tion 骨与软组织恶性肿瘤的介入综合治疗 —— 影像学诊断与影响疗效因素研究 马和平h,张学军,朝鲁孟,甄彦利,苏俐.,吕 刘江,武瑞星,李临齐,刘剑峰,鲁敏 龙, (1.内蒙古自治区医院介入放射科,2.骨科,内蒙古呼和浩特010017; 3.内蒙古医学院预防医学教研室,内蒙古呼和浩特010059) [摘要]目的探讨骨与软组织恶性肿瘤影像学诊断和介入综合治疗方法选择,疗效和预后.方法58例经骨穿活检 或手术病理证实的骨与软组织恶性肿瘤,全部经肿瘤局部供血动脉灌注化疗或超选择肿瘤血管栓塞,随访4个月至12 年,局部灌注化疗19例,超选择肿瘤血管术前栓塞8例,灌注化疗加超选择肿瘤血管栓塞31例;共行介入治疗78疗次. 结果影像学诊断与病理结果符合率为70.73;介入治疗后近期临床改善80.65,保肢率为73;局部灌注加栓塞在 疗效上优于局部单纯化疗灌注(Plt;O.05).结合手术瘤骨切除,瘤骨灭活或截肢以及免疫增强等综合治疗,2年生存率 73.2.结