目的探讨自体灭活瘤段骨与同种异体骨在四肢恶性骨肿瘤切除后骨缺损重建手术中的疗效。方法回顾性分析2015年3月—2017年12月期间共42例四肢恶性骨肿瘤患者接受肿瘤切除灭活自体瘤段骨或同种异体骨重建骨质缺损的临床资料。采用Musculos...目的探讨自体灭活瘤段骨与同种异体骨在四肢恶性骨肿瘤切除后骨缺损重建手术中的疗效。方法回顾性分析2015年3月—2017年12月期间共42例四肢恶性骨肿瘤患者接受肿瘤切除灭活自体瘤段骨或同种异体骨重建骨质缺损的临床资料。采用Musculoskeletal Tumor Society System(MSTS)和International Society of Limb Salvage(ISOLS)评分系统分别对术后功能及影像结果进行评分并对比分析。结果随访平均时间为29(15~40)个月。至随访结束,采用灭活自体瘤段骨回植治疗组MSTS平均评分26(17~31)分,ISOLS平均评分27(23~32)分;采用同种异体骨治疗组MSTS平均评分25(15~30)分,ISOLS平均评分28(24~30)分。两组患者MSTS、ISOLS评分对比统计学无明显差异。结论四肢恶性骨肿瘤切除后,使用自体灭活瘤段骨回植与同种异体骨重建,术后疗效相当,影像学评估无显著差别。展开更多
Objective: To evaluate the value of inactivated bone replantation with preservation of the epiphysis following the effective chemotherapy in avoiding postoperative discrepancy of the affected limb in children with ost...Objective: To evaluate the value of inactivated bone replantation with preservation of the epiphysis following the effective chemotherapy in avoiding postoperative discrepancy of the affected limb in children with osteosarcoma. Methods: Two children (aged 5 and 10 years, 1 male and 1 female) with osteosarcoma underwent inactivated bone replantation with preserving epiphysis following chemotherapy (MMIA protocol, including high-dose methotrexate, adriamycin and ifosfamide). After two cycles of preop-erative chemotherapy, pain vanished, the local mass shrank and there was no pain on pressing the affected parts. Sera AKP and LDH were reduced to normal levels; marked shrinkage and sclerotic changes and good margin of lesions were seen on plain radiographs and MR images. Two courses of the same protocol as preoperative chemotherapy were administered postoperatively. Results: Postoperative histological examination of the specimens demonstrated absence of vital tumor cells. Incisions healed well and no complications occurred. The replanted inactivated bone healed with host at 6 months after operation. In the two patients, no evidence was seen of metastasis and recurrence and discrepancy of the affected limbs in postoperative 36 and 48 months. Functions of the affected limbs were satisfactory. Conclusion: Inactivated bone replantation with preserving epiphysis was a viable option for osteosarcoma in children. The long-term outcomes remain to be further proven.展开更多
文摘目的探讨自体灭活瘤段骨与同种异体骨在四肢恶性骨肿瘤切除后骨缺损重建手术中的疗效。方法回顾性分析2015年3月—2017年12月期间共42例四肢恶性骨肿瘤患者接受肿瘤切除灭活自体瘤段骨或同种异体骨重建骨质缺损的临床资料。采用Musculoskeletal Tumor Society System(MSTS)和International Society of Limb Salvage(ISOLS)评分系统分别对术后功能及影像结果进行评分并对比分析。结果随访平均时间为29(15~40)个月。至随访结束,采用灭活自体瘤段骨回植治疗组MSTS平均评分26(17~31)分,ISOLS平均评分27(23~32)分;采用同种异体骨治疗组MSTS平均评分25(15~30)分,ISOLS平均评分28(24~30)分。两组患者MSTS、ISOLS评分对比统计学无明显差异。结论四肢恶性骨肿瘤切除后,使用自体灭活瘤段骨回植与同种异体骨重建,术后疗效相当,影像学评估无显著差别。
文摘Objective: To evaluate the value of inactivated bone replantation with preservation of the epiphysis following the effective chemotherapy in avoiding postoperative discrepancy of the affected limb in children with osteosarcoma. Methods: Two children (aged 5 and 10 years, 1 male and 1 female) with osteosarcoma underwent inactivated bone replantation with preserving epiphysis following chemotherapy (MMIA protocol, including high-dose methotrexate, adriamycin and ifosfamide). After two cycles of preop-erative chemotherapy, pain vanished, the local mass shrank and there was no pain on pressing the affected parts. Sera AKP and LDH were reduced to normal levels; marked shrinkage and sclerotic changes and good margin of lesions were seen on plain radiographs and MR images. Two courses of the same protocol as preoperative chemotherapy were administered postoperatively. Results: Postoperative histological examination of the specimens demonstrated absence of vital tumor cells. Incisions healed well and no complications occurred. The replanted inactivated bone healed with host at 6 months after operation. In the two patients, no evidence was seen of metastasis and recurrence and discrepancy of the affected limbs in postoperative 36 and 48 months. Functions of the affected limbs were satisfactory. Conclusion: Inactivated bone replantation with preserving epiphysis was a viable option for osteosarcoma in children. The long-term outcomes remain to be further proven.
