Kusuzaki K, Shinjo H, Murata H, Takeshita H, Hashiguchi S, Nozaki T, Emoto K, Ashihara T, Hirasawa Y
Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.
Anticancer Res. 2000 Sep-Oct;20(5C):3813-6.
We have previously reported that the doxorubicin (DOX) binding ability detected by the DOX (or adriamycin) binding assay closely correlated with the chemosensitivity of human osteosarcomas (1). We performed the present study to clarify the relationship between the DOX binding ability (%DB) and the histologic response, rate of decrease in tumor volume of malignant soft tissue tumors after preoperative chemotherapy and prognosis. Nine malignant soft tissue tumors (4 liposarcomas, 3 synovial sarcomas, one malignant fibrous histiocytoma (MFH) and one extraskeletal osteosarcoma (EOS)) which arose at the extremities of adult patients were analyzed by the DOX binding assay using freshly biopsied specimens. After preoperative chemotherapy including DOX or pirarubicin (THP), the rate of decrease in tumor volume was measured using magnetic resonance imaging, and the histologic response expressed as tumor necrosis to chemotherapy was also investigated. All the patients, apart for one, were continuously disease-free after treatment. One patient with EOS died of metastatic disease before surgery. The histologic response in 8 tumors without EOS was poor. The %DB of 5 tumors was greater than 80% (average: 95.90%), whereas that of 4 tumors was less than 80% (average: 38.33%). Although there was no correlation between the %DB and the histologic response, or prognosis, a significantly positive correlation was found between the %DB and the rate of decrease in tumor volume (r = 0.7455, p < 0.05). These results suggest that in malignant soft tissue tumors, the rate of decrease in tumor volume after chemotherapy might be a better indicator for chemosensitivity than the histologic response and also that the DOX binding ability might be a good predictor for chemosensitivity before chemotherapy.
我们之前报道过，通过阿霉素（DOX，又称多柔比星）结合试验检测到的DOX结合能力与人骨肉瘤的化疗敏感性密切相关(1)。我们进行了本研究，以阐明DOX结合能力（%DB）与组织学反应、成人患者四肢恶性软组织肿瘤术前化疗后肿瘤体积减小率及预后之间的关系。使用新鲜活检标本，通过DOX结合试验分析了9例发生于成年患者四肢的恶性软组织肿瘤（4例脂肪肉瘤、3例滑膜肉瘤、1例恶性纤维组织细胞瘤（MFH）和1例骨外骨肉瘤（EOS））。在包括DOX或吡柔比星（THP）的术前化疗后，使用磁共振成像测量肿瘤体积减小率，并研究作为化疗肿瘤坏死表现的组织学反应。除1例患者外，所有患者治疗后均持续无病生存。1例EOS患者术前死于转移性疾病。8例无EOS的肿瘤组织学反应较差。5例肿瘤的%DB大于80%（平均：95.90%），而4例肿瘤的%DB小于80%（平均：38.33%）。虽然%DB与组织学反应或预后之间无相关性，但%DB与肿瘤体积减小率之间存在显著正相关（r = 0.7455，p < 0.05）。这些结果表明，在恶性软组织肿瘤中，化疗后肿瘤体积减小率可能比组织学反应更能作为化疗敏感性的指标，并且DOX结合能力可能是化疗前化疗敏感性的良好预测指标。
