手术切除联合化疗治疗软组织肉瘤的疗效分析
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摘要
目的探讨手术切除联合化疗与单纯手术躯干及肢体软组织肉瘤患者预后的影响。方法本文回顾性分析2012年08月01日至2018年01月31日在新疆医科大学第一附属医院仅行手术或手术治疗联合化疗的69例软组织肉瘤患者的病例资料,66例患者得到随访。结果手术联合化疗治疗组32例,化疗周期1-8个,单纯手术组34例。对病例进行单因素进行分析,探讨影响无病生存时间(disease free survival,DFS)和总生存时间(overall survival,OS)的临床因素。联合治疗组中位随访时间为36个月(6～64个月),单纯手术组为38个月(5～70个月)。联合治疗组局部复发4例(12.5%),远处转移1例(3.2%),死亡1例(3.2%);单纯手术组局部复发16例(47.06%),远处转移8例(23.53%),死亡5例(15.6%)。单因素分析显示中位无病生存时间与治疗方式、组织学分级相关。单因素分析显示总生存时间与入院情况(初发、复发)、治疗方式、组织学分级相关。结论对于手术切除联合化疗后的软组织肉瘤患者较单纯手术治疗可明显延长无病生存时间及总生存时间。
Objective To investigate the effect of surgical resection combined with chemotherapy on the prognosis of patients with simple trunk and limb soft tissue sarcoma. Methods This article retrospectively analyzed the case data of 69 patients with soft tissue sarcoma who underwent surgery or surgery combined with chemotherapy in the First Affiliated Hospital of Xinjiang Medical University from August 01, 2012 to January 31, 2018. 66 patients were followed up. Results 32 patients underwent surgery combined with chemotherapy, 1-8 chemotherapy cycles, and 34 patients underwent surgery alone. Case factors were analyzed to investigate the clinical factors affecting disease free survival(DFS) and overall survival(OS). The median follow-up time was 36 months(range, 6 to64 months) in the combination group and 38 months(range, 5 to 70 months) in the surgery alone group. There were 4 cases(12.5%)with local recurrence, 1 case(3.2%) with distant metastasis, and 1 case(3.2%) with death. There were 16 cases(47.06%) with local recurrence and 8 cases with distant metastasis in operation group(23.53%).), 5 cases of death(15.6%). Univariate analysis showed that the median disease-free survival time was related to treatment and histological grade. Univariate analysis showed that overall survival was associated with admission(primary, recurrent), treatment, and histological grade. Conclusion Patients with soft tissue sarcoma after surgical resection combined with chemotherapy can significantly prolong disease-free survival time and overall survival time.
Objective To investigate the effect of surgical resection combined with chemotherapy on the prognosis of patients with simple trunk and limb soft tissue sarcoma. Methods This article retrospectively analyzed the case data of 69 patients with soft tissue sarcoma who underwent surgery or surgery combined with chemotherapy in the First Affiliated Hospital of Xinjiang Medical University from August 01, 2012 to January 31, 2018. 66 patients were followed up. Results 32 patients underwent surgery combined with chemotherapy, 1-8 chemotherapy cycles, and 34 patients underwent surgery alone. Case factors were analyzed to investigate the clinical factors affecting disease free survival(DFS) and overall survival(OS). The median follow-up time was 36 months(range, 6 to64 months) in the combination group and 38 months(range, 5 to 70 months) in the surgery alone group. There were 4 cases(12.5%)with local recurrence, 1 case(3.2%) with distant metastasis, and 1 case(3.2%) with death. There were 16 cases(47.06%) with local recurrence and 8 cases with distant metastasis in operation group(23.53%).), 5 cases of death(15.6%). Univariate analysis showed that the median disease-free survival time was related to treatment and histological grade. Univariate analysis showed that overall survival was associated with admission(primary, recurrent), treatment, and histological grade. Conclusion Patients with soft tissue sarcoma after surgical resection combined with chemotherapy can significantly prolong disease-free survival time and overall survival time.
引文
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[17]王冰,于秀淳,许宋锋,等.新辅助化疗治疗肢体软组织肉瘤28例报告[J].中国骨与关节杂志,2015,4(1).
[2]American Cancer Society:Cancer facts&fgures 2013[J].Atlanta:American Cancer Society,2013.
[3]rustaci S,de Paoli A.Hdoli E,et al.Oncology[J],2003,65(Suppl 2)80-84.
[4]Kasper B,Gil T,D’Hondt V,et al.Novel treatment strategies for soft tissue fⅡa’eonla[J].Crit Rev Oncoi Hematol,2007,62(1):9-15.
[5]于秀淳,刘晓平,周银,等.肢体恶性软组织肿瘤的保肢治疗[J].中国骨肿瘤骨病,2002,1(1):32-34
[6]Nielsen OS,Judson I,van Hoesel Q,et al.Effect of high-dose ifosfamide in advanced soft tissue sarcomas.A multicentre phase II study of the EORTCSoft Tissue and Bone Sarcoma Group[J].Eur J Cancer,2000,36(1):61-67.
[7]Judson I,Radford JA,Harris M,et al.Randomised phase II trial of pegylated liposomal doxorubicin(DOXIL/CAELYX)versus doxorubicin in thetreatment of advanced or metastatic soft tissue sarcoma:a study by the EORTC Soft Tissue and Bone Sarcoma Group[J].Eur J Cancer,2001,37(7):870-877
[8]Vraa S,Keller J,Nielsen OS,et al.Prognostic factors in soft tissue sarcomas:the Aarhus experience[J].Eur J Cancer,1998,34(12):1876-1882.
[9]Steward WP,Verweij J,Somers R,et al.Granulocytemacrophage colonystimulating factor allows safe escalation of dose-intensity of chemotherapy in metastatic adult soft tissue sarcoma:a study of the European Organization for Research and Treatment of Cancer Soft Tissue ang Bone Sarcoma[J].Group JClin Oncol,1993,11(1):15-21.
[10]Krikelis D,Judson I.Role of chemotherapy in the management of soft tissue sarcomas[J].Expert Rev Anticancer Ther,2010,10(2):249-260.
[11]James DC,Moss’Radiation Oncology 7th ed.St louis[J].Mosby-Year Book Inc,1994:851-880.
[12]Pervaiz N,Colterjohn N,Farrokhyar F,et al.A systematic meta analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma[J].Cancer,2008,113(3):573-581.
[13]刘佳勇,方志伟.2011版《美国综合癌症网络软组织肉瘤临床实践指南》解读[J].中华骨与关节杂志,2011:6.
[14]von Mehren M,Randall RL,Benjamin RS,et al.Soft tissue sarcoma,version 22014[J].J Natl Compr Canc Netw,2014,12(4):473-483.
[15]Canter RJ,Beal S,Borys D,et al.Interaction of histologic subtype and histologic grade in predicting survival for soft·tissue sarcomas[J].J Am Col Surg,2010,210(2):191-198.e2.
[16]Canter RJ,Beal S,Borys D,et al.Interaction of histologic subtype and histologic grade in predicting survival for soft·tissue sarcomas[J].J Am Coll Surg,2010,210(2):191-198.e2.
[17]王冰,于秀淳,许宋锋,等.新辅助化疗治疗肢体软组织肉瘤28例报告[J].中国骨与关节杂志,2015,4(1).