Lane J M, Hurson B, Boland P J, Glasser D B
Clin Orthop Relat Res. 1986 Mar(204):93-110.
Guarded optimism could be clearly stated for the treatment of osteogenic sarcoma. Improved methods of diagnosis and staging have been made possible by the computed tomography (CT) scan and other new modalities. The advent of pre- and postoperative chemotherapy has significantly enhanced survival rates that are now approaching 85%. Improved concepts of en bloc resection and better reconstructive techniques suggest that limb salvage procedures are not only possible but can provide excellent functional results in the context of muscle loss. Continued work must be directed toward improving the reconstructive techniques to provide implants with permanence, particularly for young patients and to clearly define the indications for such procedures. Patients presenting with thoracic lesions, although difficult to treat, can expect a 30%--45% long-term survival following repetitive thoracotomies.
对于骨肉瘤的治疗,可以明确表达出谨慎的乐观态度。计算机断层扫描(CT)及其他新的检查手段使诊断和分期方法得到了改进。术前和术后化疗的出现显著提高了生存率,目前已接近85%。整块切除概念的改进和更好的重建技术表明,保肢手术不仅可行,而且在存在肌肉损失的情况下也能提供良好的功能效果。必须继续努力改进重建技术,以使植入物更持久,特别是对于年轻患者,并明确此类手术的适应症。出现胸部病变的患者,尽管治疗困难,但在反复开胸手术后有望获得30%至45%的长期生存率。