Chuman H
Bone and Soft Part Division, National Kyushu Cancer Center, Fukuoka, Japan.
Gan To Kagaku Ryoho. 2000 Feb;27(2):192-202.
In the present paper, we review the evidence for chemotherapy in patients with bone and soft part sarcoma and discuss the contributions and improvements made by chemotherapy to the treatment of patients with bone and soft part sarcoma. In the osteosarcoma and Ewing's sarcoma family, neoadjuvant and adjuvant chemotherapy have improved the 5-year disease-free survival to 60%, and limb-salvage operations have improved this to 70-80% in cases of non-metastatic malignant bone tumor. Several trials were conducted in order to overcome rate relapses and metastatic bone sarcoma. With osteosarcoma, thoracotomy improved the survival of lung metastatic patients, but CDDP-ADM branch switched according to the neoadjuvant chemotherapy and failed to elevate the continuous disease-free survival of patients. Dose intensive use of cytotoxic drugs with G-CSF or autologous bone marrow transplantation and multidrug programs were conducted in preliminary studies and achieved favorable results in a high risk factors group for tumors of the Ewing's sarcoma family. Surgical techniques have brought improvements in the treatment of soft tissue sarcoma, but there has been no impact by chemotherapy. Ifosfamide and adriamycin combination is being evaluated in the treatment of local advanced and metastatic soft part sarcoma by local control rate or survival from relapse.
在本文中，我们回顾了骨肉瘤和软组织肉瘤患者化疗的证据，并讨论了化疗对骨肉瘤和软组织肉瘤患者治疗的贡献及改进。在骨肉瘤和尤因肉瘤家族中，新辅助化疗和辅助化疗已将5年无病生存率提高到60%，对于非转移性恶性骨肿瘤患者，保肢手术已将这一比例提高到70 - 80%。为了克服复发率和转移性骨肉瘤，进行了多项试验。对于骨肉瘤，开胸手术提高了肺转移患者的生存率，但顺铂-阿霉素方案根据新辅助化疗进行了调整，未能提高患者的持续无病生存率。在初步研究中，对细胞毒性药物进行大剂量使用并联合粒细胞集落刺激因子或自体骨髓移植以及多药方案，在尤因肉瘤家族肿瘤的高危因素组中取得了良好效果。手术技术已在软组织肉瘤治疗中带来改进，但化疗并无影响。异环磷酰胺和阿霉素联合用药正在通过局部控制率或复发后的生存率来评估其在局部晚期和转移性软组织肉瘤治疗中的效果。
