Covarrubias-Espinoza G, Goiricelaya-Asia J M, Vásquez-Bojórquez R, López-Cervantes G
Servicio de Oncología, Hospital Infantil del Estado de Sonora, Hermosillo, México.
Bol Med Hosp Infant Mex. 1991 Mar;48(3):159-63.
The authors describe the results of five pediatric patients with nonmetastatic osteosarcoma of an extremity, admitted from 1987 to 1989 to the Hospital Infantil del Estado de Sonora. Four patients presented with their primary tumor located at the distal end of the femur, whereas one had a primary lesion of the humerus. All of them received preoperative chemotherapy consisted of two cycles of cisplatin and adriamycin. One of the patients presented immediate complications after first cicle and died due to overwhelming sepsis by Candida albicans. Surgery was an amputation in one patients and block ressection in three cases. Necrosis was good in three cases, fair in one. Postoperative chemotherapy consisted of bleomycin, cyclophosphamide and dactinomycin every four weeks alternated with cisplatin plus adriamycin. One of the three patients, in which block ressection was made, had a local recurrence 12 months after diagnosis, without metastasis. He underwent desarticulation and died four months later of leukoencephalopathy and no tumor was found on necropsy. Three patients have remained continuously free of disease with follow up of 20, 26 and 31 months after diagnosis and are out of chemotherapy since 5, 12 and 17 months, respectively. In two of them the affected extremity still is safe.
作者描述了1987年至1989年期间收治于索诺拉州儿童医院的5例肢体非转移性骨肉瘤患儿的治疗结果。4例患者的原发性肿瘤位于股骨远端，1例患者的原发性病变位于肱骨。所有患者均接受了术前化疗，化疗方案为顺铂和阿霉素两个周期。其中1例患者在第一个周期后出现即刻并发症，因白色念珠菌败血症死亡。手术方式为1例截肢，3例大块切除。3例坏死情况良好，1例一般。术后化疗方案为每四周交替使用博来霉素、环磷酰胺和放线菌素，并联合顺铂和阿霉素。3例行大块切除的患者中，1例在诊断后12个月出现局部复发，无转移。该患者接受了关节离断术，4个月后死于白质脑病，尸检未发现肿瘤。3例患者在诊断后分别随访20、26和31个月，持续无病生存，分别在5、12和17个月后停止化疗。其中2例患者的患侧肢体仍然安全。
