Quintana J, Beresi V, DelPozo H, Latorre J J, Henriquez A, Chamas N, Diaz V, Geldres V, Sepulveda L, Macho L
Servicio de Oncología, Hospital Luis Calvo Mackenna, Santiago, Chile.
Am J Pediatr Hematol Oncol. 1991 Fall;13(3):269-73. doi: 10.1097/00043426-199123000-00004.
From January 1983 to August 1987, 29 evaluable patients with high-grade osteosarcoma were treated in our institution with preoperative intra-atrial cisplatin, 100 mg/m2 every 14 days for three courses. Surgery was done on day 42. Surgery consisted of limb salvage in six, amputations in 15, and disarticulations in eight. Postoperative chemotherapy included Adriamycin (ADR), 45 mg/m2 for 2 days every 6 weeks, alternated with cisplatin 120 mg/m2 every 6 weeks. The nephrotoxicity (18 out 29) was reversible in all cases. Cardiotoxicity was prominent; it was observed in 31% of patients. In six, there was congestive heart failure, but there were no fatal cases. The hematological toxicity was severe. There were three patients with fatal infections who had no evidence of disease after they had finished treatment. Seventeen of 29 patients (58.6%) were good responders and showed 60-100% tumoral necrosis after intra-atrial cisplatin. The 6-year, relapse-free survival rate was 58.6%--70.5% for the good responders and 41.6% for the poor responders (p less than 0.05). The size of the tumor was the other important prognostic factor. The rate of 6-year, relapse-free survival was 73.6% for small tumors (those measuring less than 100 cm2) and 33.3% for large tumors (p less than 0.05).
1983年1月至1987年8月，我院对29例可评估的高级别骨肉瘤患者进行了术前心房内顺铂治疗，每14天100mg/m²，共三个疗程。于第42天进行手术。手术方式包括保肢手术6例、截肢手术15例、关节离断手术8例。术后化疗包括阿霉素（ADR），每6周45mg/m²，连用2天，与每6周120mg/m²的顺铂交替使用。肾毒性（29例中有18例）在所有病例中均可逆转。心脏毒性较为突出，31%的患者出现该毒性。6例出现充血性心力衰竭，但无死亡病例。血液学毒性严重。有3例患者在完成治疗后无疾病证据，但发生了致命感染。29例患者中有17例（58.6%）为良好反应者，心房内顺铂治疗后肿瘤坏死率为60% - 100%。良好反应者的6年无复发生存率为58.6% - 70.5%，不良反应者为41.6%（p<0.05）。肿瘤大小是另一个重要的预后因素。小肿瘤（面积小于100cm²）的6年无复发生存率为73.6%，大肿瘤为33.3%（p<0.05）。
