Trapeznikov N N, Amiraslanov A T
All-Union Cancer Research Center, USSR Academy of Medical Sciences, Moscow.
Clin Orthop Relat Res. 1991 Sep(270):107-12.
Three hundred and ninety-three patients with IIB osteosarcoma were treated at the author's institution between 1955 and 1986. In the first stage of the study, 88 patients were treated with surgery only. The five-year disease-free survival rate was 7%. In the second stage of the study, the efficacy of preventive chemotherapy after radical surgery was studied in 55 patients. The five-year disease-free survival rate was 34.4%. In the third stage of the study, the efficacy of combination therapy consisting of preoperative treatment, limb-saving surgery, and preventive chemotherapy was studied in 66 patients. The five-year disease-free survival rate was 35.5%. The authors examined results in 21 patients with Grade IV responses to evaluate the relationship between prognosis and morphogenic changes after preoperative radiotherapy and chemotherapy. The five-year disease-free survival rate was 57.9%. In the fourth stage of the study (conducted in 1986), two regimens of preoperative chemotherapy were initiated. The first regimen consists of intraarterial platinum infusions to patients with lower extremity bone damage. The second regimen consists of high-dose methotrexate infusions. The preliminary conclusion is that primary tumor damage is significantly more marked after intraarterial cisplatin infusion.
1955年至1986年间，作者所在机构共治疗了393例IIB期骨肉瘤患者。在研究的第一阶段，88例患者仅接受了手术治疗。五年无病生存率为7%。在研究的第二阶段，对55例患者进行了根治性手术后预防性化疗的疗效研究。五年无病生存率为34.4%。在研究的第三阶段，对66例患者进行了术前治疗、保肢手术和预防性化疗联合治疗的疗效研究。五年无病生存率为35.5%。作者检查了21例IV级反应患者的结果，以评估术前放疗和化疗后预后与形态学变化之间的关系。五年无病生存率为57.9%。在研究的第四阶段（于1986年进行），启动了两种术前化疗方案。第一种方案是对下肢骨损伤患者进行动脉内铂输注。第二种方案是大剂量甲氨蝶呤输注。初步结论是，动脉内顺铂输注后原发肿瘤损伤明显更显著。
