中国肿瘤临床对影响新辅助化疗后骨肉瘤危险度的临床因素分析.PDFVIP

1408 中国肿瘤临床 2010年第37 卷第24 期 对影响新辅助化疗后骨肉瘤危险度的临床因素分析 于秀淳 王 强① 分析影响新辅助化疗后骨肉瘤危险度的临床因素，探索评价新辅助化疗后高危骨肉瘤的临床指标。 回顾 摘要 目的： 方法： 分析1999年12 月～2006 年10 月在济南军区总医院接受新辅助化疗的55 例患者的临床特点、血液学检查及X 线片表现等不同指 标。随访期内出现复发、转移或死亡的患者归为高危组；反之归为低危组。运用统计学方法，分析各指标在高、低危患者间的差 异。 55 例患者中高危组25 例（45%）；正常生存者30 例（55%）。经统计学分析发现除了化疗前肿瘤体积、化疗前AKP、化疗 结果： 前LDH 在两组之间存在差异外，余各项指标在两组之间均无统计学差异。 当化疗前AKP ≥250IU/L、化疗前LDH ≥240IU/ 结论： 3 L、化疗前肿瘤体积≥150cm 即表明该类患者有较高的危险性，可考虑为高危骨肉瘤，预后较差。 关键词 骨肉瘤 新辅助化疗 危险度 临床特点 多因素分析 doi:10.3969/j.issn. 1000-8179.2010.24.008 MultivariateAnalysisofClinicalFactorstoDetermineRiskLevelforPatientswith OsteosarcomaafterNeoadjuvantChemotherapy 1 2 YU Xiuchun , WANG Qiang Corresponding author: YU Xiuchun, E-mail: yxch36@ 1Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan 250031, China 2Orthopedic Department, People ’s Hospital of Xuecheng District, Zaozhuang 277000, China Abstract Objective: To analyze the clinical factors that separate low- and high-risk osteosarcoma after neoadjuvant chemotherapy. Methods: Many indices, including clinical manifestation, hematological examination and X-ray changes, from 55 patients with osteosarcoma who were treated with neoadjuvant chemotherapy in the study department from De- cember 1999 to December 2006 were reviewed. During follow-up, the patients were classified as having high-risk osteosar- coma if recurrence, metastasis or death occurred. If these events did not occur, the patients were classifi