Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ultrasound Med Biol. 2012 Feb;38(2):202-8. doi: 10.1016/j.ultrasmedbio.2011.11.011.
The aim of this study was to evaluate the vascular parameters of the proximal peripheral arteries of limbs by color Doppler ultrasonography (CDUS) in individuals with osteogenic sarcoma (OGS) after neoadjuvant chemotherapy and their relation to the tumor necrosis rate. We recruited 50 individuals with osteogenic sarcoma who were scheduled for neoadjuvant chemotherapy before elective surgery from 2003 to 2010. Once enrolled, we evaluated these 50 subjects using color Doppler sonography to identify vascular parameters of tumor vessels before and after neoadjuvant therapy. The vascular parameters of the proximal peripheral arteries of limbs (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI]) and tumor neovascularity were compared before and after neoadjuvant chemotherapy using CDUS. Before chemotherapy, the PSV, EDV and RI differed significantly between the diseased and contralateral normal limbs (p < 0.001). Among the factors relating to the tumor necrosis rate before chemotherapy, the EDV of the diseased limb (p = 0.047) and tumor neovascularity (p = 0.027) showed significant differences. After chemotherapy, the PSV of the diseased limb (p = 0.022) and the difference in PSV between the diseased and contralateral limbs (p = 0.003) showed significant differences. The vascular parameters of the proximal peripheral arteries of limbs owing to tumor burden differ significantly between the diseased and contralateral normal limbs. For individuals with osteogenic sarcoma who still have a higher difference in PSV between the diseased and contralateral limbs after chemotherapy, another course of chemotherapy after surgery and close follow-up should be considered.
本研究旨在通过彩色多普勒超声(CDUS)评估骨肉瘤(OGS)患者新辅助化疗前后肢体近端周围动脉的血管参数及其与肿瘤坏死率的关系。我们招募了 2003 年至 2010 年间计划接受新辅助化疗的 50 名骨肉瘤患者。一旦入选,我们使用彩色多普勒超声评估这些 50 名患者,以确定新辅助治疗前后肿瘤血管的血管参数。使用 CDUS 比较新辅助化疗前后肢体近端周围动脉的血管参数(收缩期峰值速度[PSV]、舒张末期速度[EDV]、阻力指数[RI])和肿瘤新生血管。化疗前,患病肢和对侧正常肢的 PSV、EDV 和 RI 差异有统计学意义(p<0.001)。在与化疗前肿瘤坏死率相关的因素中,患病肢的 EDV(p=0.047)和肿瘤新生血管(p=0.027)差异有统计学意义。化疗后,患病肢的 PSV(p=0.022)和患病肢与对侧肢之间 PSV 的差异(p=0.003)差异有统计学意义。肿瘤负荷引起的肢体近端周围动脉的血管参数在患病肢和对侧正常肢之间有明显差异。对于化疗后患病肢和对侧肢之间 PSV 差异仍然较高的骨肉瘤患者,术后应考虑再进行一轮化疗,并密切随访。