Machak G N, Polotskiĭ B E, Meluzova O M, Chernov I S, Aliev M D
Vopr Onkol. 2010;56(2):220-5.
Our investigation involved 27 patients with osteosarcoma and 2--malignant fibrous histiocytoma of long tubular bones treated at the Center's Clinics (2001-2008). Two regimes were used for relapsed tumor: ifosamide up to 5-10 g/m2 (median 7.5) + carboplatin 300-750 mg/m2 (median 350) + etoposide 300-500 mg/m2 (median 450) (ICE), or doxorubicin 50-80 mg/m2 (median 60) (ICA). Surgical treatment used atypical resection of the lung or precision excision of metastasis. Median post-relapse follow-up was 18 months. When ICE was used, partial effect was reported in 3 (17.6%), stabilization--10 (58.8%), and tumor progression--4 (23.5%); ICA: partial effect--3 (25%), stabilization--6 (50%), tumor progression--3 (25%). Metastases were removed after a course of chemotherapy in 16 cases. Overall 3- and 5-year survival was 51.6 +/- 11% and 34.4 +/- 16%, respectively. Relatively more aggressive was the course of the disease in cases of early relapse (< or = 12 months), combination of local recurrence and distant metastasis and those who had not survived until a second surgical remission. Hence, timely combination therapy of relapsed high-grade osteosarcoma may secure relatively long remission in 35-40.3%.
我们的研究纳入了在该中心诊所接受治疗的27例骨肉瘤患者以及2例长管状骨恶性纤维组织细胞瘤患者（2001 - 2008年）。对于复发性肿瘤采用了两种治疗方案：异环磷酰胺剂量高达5 - 10 g/m²（中位数7.5）+卡铂300 - 750 mg/m²（中位数350）+依托泊苷300 - 500 mg/m²（中位数450）（ICE方案），或多柔比星50 - 80 mg/m²（中位数60）（ICA方案）。手术治疗采用肺部非典型切除术或转移灶精准切除术。复发后的中位随访时间为18个月。采用ICE方案时，报告部分缓解的有3例（17.6%），病情稳定的有10例（58.8%），肿瘤进展的有4例（23.5%）；采用ICA方案时，部分缓解的有3例（25%），病情稳定的有6例（50%），肿瘤进展的有3例（25%）。16例患者在化疗疗程后切除了转移灶。总体3年和5年生存率分别为51.6 ± 11%和34.4 ± 16%。在早期复发（≤12个月）、局部复发与远处转移并存以及未存活至第二次手术缓解的病例中，疾病进展相对更具侵袭性。因此，复发性高级别骨肉瘤的及时联合治疗可能使35 - 40.3%的患者获得相对较长时间的缓解。
