Gravel Charles A, Le T Toan, Chapman Michael W
Orthopaedic Research Laboratories, University of California, Davis, Sacramento, USA.
Clin Orthop Relat Res. 2003 Jul(412):213-24. doi: 10.1097/01.blo.0000069002.56218.99.
Neoadjuvant chemotherapy potentially can have an adverse effect on bone healing in distraction osteogenesis whether given before or concomitant with distraction osteogenesis. It was the purpose of the current study to determine if administration of chemotherapy before distraction adversely affects bone generation in distraction osteogenesis. Twenty-four adult dairy goats were divided randomly into two groups: a control group having distraction osteogenesis only and a chemotherapy group, receiving one course of Adriamycin before distraction osteogenesis. The animals were sacrificed at 6 weeks, 12 weeks, or 24 weeks and the lengthened tibias were evaluated by radiologic studies, biomechanical testing, and histologic analysis. All goats receiving chemotherapy showed systemic adverse effects. In a multifactorial analysis of the lengthened bones, there was no statistically significant difference between the control goats versus goats that received chemotherapy; indicating that there was no sustained inhibitory effect on bone formation by the chemotherapy. These findings suggest that a prior course of chemotherapy with Adriamycin may not be a contraindication to limb lengthening for limb salvage after resection of an osteosarcoma.
新辅助化疗无论在牵张成骨之前给予还是与牵张成骨同时进行，都可能对牵张成骨中的骨愈合产生不利影响。本研究的目的是确定在牵张之前给予化疗是否会对牵张成骨中的骨生成产生不利影响。将24只成年奶山羊随机分为两组：一组为仅进行牵张成骨的对照组，另一组为化疗组，在牵张成骨之前接受一个疗程的阿霉素治疗。在6周、12周或24周时对动物实施安乐死，并通过放射学研究、生物力学测试和组织学分析对延长的胫骨进行评估。所有接受化疗的山羊均出现全身不良反应。在对延长骨骼的多因素分析中，对照山羊与接受化疗的山羊之间没有统计学上的显著差异；这表明化疗对骨形成没有持续的抑制作用。这些发现表明，对于骨肉瘤切除术后肢体挽救的肢体延长，先前使用阿霉素进行的化疗疗程可能不是禁忌证。
