Krieg A H, Mani M, Speth B M, Stalley P D
Orthopaedic Department, University Children's Hospital (UKBB), P. O. Box, Römergasse 8, 4005 Basel, Switzerland.
J Bone Joint Surg Br. 2009 Mar;91(3):395-400. doi: 10.1302/0301-620X.91B3.21164.
We review the treatment of pelvic Ewing's sarcoma by the implantation of extracorporeally-irradiated (ECI) autografts and compare the outcome with that of other reported methods. We treated 13 patients with ECI autografts between 1994 and 2004. There were seven males and six females with a median age of 15.7 years (interquartile range (IQR) 12.2 to 21.7). At a median follow-up of five years (IQR 1.8 to 7.4), the disease-free survival was 69% overall, and 75% if one patient with local recurrence after initial treatment elsewhere was excluded. Four patients died from distant metastases at a mean of 17 months (13 to 23). There were three complications which required operative intervention; one was a deep infection which required removal of the graft. The functional results gave a mean Musculoskeletal Tumor Society score of 85% (60% to 97%), a mean Toronto extremity salvage score of 86% (69% to 100%) and a mean Harris hip score of 92 (67 to 100). We conclude that ECI grafting is a suitable form of treatment for localised and resectable pelvic Ewing's sarcoma.
我们回顾了通过植入体外照射（ECI）自体移植物治疗骨盆尤文肉瘤的情况，并将结果与其他报道的方法进行了比较。1994年至2004年间，我们用ECI自体移植物治疗了13例患者。其中男性7例，女性6例，中位年龄15.7岁（四分位间距（IQR）为12.2至21.7岁）。中位随访5年（IQR为1.8至7.4年），总体无病生存率为69%，如果排除1例在其他地方初始治疗后局部复发的患者，则为75%。4例患者死于远处转移，平均时间为17个月（13至23个月）。有3例并发症需要手术干预；1例为深部感染，需要取出移植物。功能结果显示，肌肉骨骼肿瘤学会平均评分为85%（60%至97%），多伦多肢体挽救平均评分为86%（69%至100%），哈里斯髋关节平均评分为92分（67至100分）。我们得出结论，ECI移植是治疗局限性和可切除骨盆尤文肉瘤的一种合适治疗方式。
