Hendershot Eleanor, Pappo Alberto, Malkin David, Sung Lillian
Division of Hematology/Oncology, Hospital for Sick Children in Toronto, Ontario, Canada.
J Pediatr Oncol Nurs. 2006 Jul-Aug;23(4):176-81. doi: 10.1177/1043454206289786.
Tumor necrosis following preoperative chemotherapy in patients with osteosarcoma is a predictor of overall survival. With modern therapies, 45% of patients are expected to achieve more than 90% tumor necrosis. Investigators at the authors' center, however, increasingly noted that patients were experiencing inferior necrosis responses. A retrospective study of treated patients at the center was undertaken to examine this. The purpose of this study was to determine (1) whether the number of patients with favorable histological responses had changed over time and (2) whether the percentage of patients with favorable responses was similar to published outcomes. Chart reviews were performed on patients treated from 1993 to 2003 according to the Pediatric Oncology Group 9351, regimen A protocol. Twenty-one patients met all eligibility requirements; 52% of patients had more than 90% necrosis. No correlation existed between degree of necrosis and year of treatment (r = 0.06; P = .8). Patients with osteosarcoma treated at the authors' institution have comparable tumor necrosis responses to published outcomes, and no change occurred over time. This study stresses the importance of rigorous retrospective reviews before implementing treatment changes.
骨肉瘤患者术前化疗后的肿瘤坏死情况是总生存期的一个预测指标。采用现代疗法时，预计45%的患者肿瘤坏死率超过90%。然而，作者所在中心的研究人员越来越多地注意到患者的坏死反应较差。为此，对该中心接受治疗的患者进行了一项回顾性研究。本研究的目的是确定：（1）组织学反应良好的患者数量是否随时间发生了变化；（2）反应良好的患者百分比是否与已发表的结果相似。根据儿童肿瘤学组9351方案A，对1993年至2003年期间接受治疗的患者进行了病历审查。21名患者符合所有入选标准；52%的患者坏死率超过90%。坏死程度与治疗年份之间无相关性（r = 0.06；P = 0.8）。在作者所在机构接受治疗的骨肉瘤患者的肿瘤坏死反应与已发表结果相当，且随时间未发生变化。本研究强调了在实施治疗改变之前进行严格回顾性审查的重要性。
