Bhagat S, Sharma H, Pillai D S, Jane M J
Department of Trauma and Orthopaedics, Wishaw General Hospital, Wishaw, United Kingdom.
J Orthop Surg (Hong Kong). 2008 Dec;16(3):333-8. doi: 10.1177/230949900801600313.
To review various treatment modalities on outcome of patients with pelvic Ewing's sarcoma.
Between January 1948 and December 2004, 18 male and 15 female patients aged 3 to 48 (mean, 20) years with pelvic Ewing's sarcoma were retrospectively reviewed from the Scottish Bone Tumour Registry.
The commonest site involved was the ilium. The main presenting symptom was pain, followed by swelling and restricted hip movements. Treatments included surgery, radiotherapy, chemotherapy, or any of them in combination. Patients who had no metastasis at presentation (p<0.01) and underwent chemotherapy with ifosfamide (p<0.01) had significantly longer survival. Age (p=0.09), gender (p=0.95), delay in presentation (p=0.31), tumour site (p=0.9), surgery (p=0.73), and radiotherapy (p=0.23) were not predictive of survival in the univariate analysis. The 5-year event-free survival rate in patients with no metastasis at presentation was 35%.
Intense multi-agent neo-adjuvant chemotherapy including ifosfamide followed by wide excision and postoperative radiation are recommended. Local therapy should not take precedence over or interfere with systemic chemotherapy.
回顾骨盆尤文肉瘤患者不同治疗方式的疗效。
从苏格兰骨肿瘤登记处回顾性分析了1948年1月至2004年12月期间18例男性和15例女性骨盆尤文肉瘤患者，年龄3至48岁（平均20岁）。
最常受累部位是髂骨。主要症状为疼痛，其次是肿胀和髋关节活动受限。治疗方法包括手术、放疗、化疗或联合应用。初诊时无转移（p<0.01）且接受异环磷酰胺化疗（p<0.01）的患者生存期明显更长。单因素分析中，年龄（p=0.09）、性别（p=0.95）、就诊延迟（p=0.31）、肿瘤部位（p=0.9）、手术（p=0.73）和放疗（p=0.23）均不能预测生存期。初诊时无转移患者的5年无事件生存率为35%。
推荐采用包括异环磷酰胺的强化多药新辅助化疗，随后行广泛切除及术后放疗。局部治疗不应优先于或干扰全身化疗。
