Kaçmaz İsmail Eralp, Keçeci Burçin, Basa Can Doruk, Sabah Dündar
Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, İzmir, Turkey.
Department of Orthopaedics and Traumatology, Ege University, School of Medicine, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2020 Jan;54(1):42-48. doi: 10.5152/j.aott.2020.01.601.
The aim of this study was to compare the results of chemotherapy or combined chemotherapy-radiation therapy with surgical intervention following neodjuvant therapy in pelvic Ewing's sarcoma patients.
The study population consisted of 39 patients with pelvic Ewing's sarcoma treated in our clinic between 1994 and 2014. Of these patients, 28 patients (11 boys and 17 girls; mean age: 19.57±6.8 years) were treated with chemotherapy and radiation therapy and the remaining 11 patients (9 boys and 2 girls; mean age: 18.64±8.1 years) patients underwent surgical intervention after neoadjuvant chemotherapy or chemotherapy plus radiation therapy. Internal hemipelvectomy was performed in 10 patients, and external hemipelvectomy was performed in one patient. Survival rates were compared between the surgical and non-surgical treatment groups. Predictive factors, such as treatment protocol (surgery, neoadjuvant chemotherapy, definitive radiotherapy), mass localisation, mass size, presence of metastasis at the time of diagnosis, and presence of late metastases were compared between the groups. The effects of each variable on survival were also examined.
The overall 3- and 5-year survival rates of the 28 non-surgical patients were 41.4% and 26.1%, respectively, while those of the surgical patients were 53% and 35.4%, respectively (p=0.777). Large mass size, presence of metastasis at the time of diagnosis, and presence of late metastases were significantly associated with lower survival rates.
The survival rates of the patients who underwent surgery were higher than those of non-surgical patients, although the difference was not statistically significant. Definitive radiation and chemotherapy would be preferable in selected cases, such as patients with sacral localisation, without surgical intervention.
Level III, Therapeutic Study.
本研究旨在比较盆腔尤因肉瘤患者新辅助治疗后化疗或放化疗联合手术干预的效果。
研究对象为1994年至2014年在我院接受治疗的39例盆腔尤因肉瘤患者。其中，28例患者（11例男孩和17例女孩；平均年龄：19.57±6.8岁）接受了化疗和放疗，其余11例患者（9例男孩和2例女孩；平均年龄：18.64±8.1岁）在新辅助化疗或化疗加放疗后接受了手术干预。10例行内半骨盆切除术，1例行外半骨盆切除术。比较手术和非手术治疗组的生存率。比较两组间的预测因素，如治疗方案（手术、新辅助化疗、根治性放疗）、肿块位置、肿块大小、诊断时是否存在转移以及是否存在晚期转移。还研究了每个变量对生存的影响。
28例非手术患者的3年和5年总生存率分别为41.4%和26.1%，而手术患者的3年和5年总生存率分别为53%和35.4%（p=0.777）。肿块体积大、诊断时存在转移以及存在晚期转移与较低的生存率显著相关。
接受手术的患者生存率高于未接受手术的患者，尽管差异无统计学意义。对于某些特定情况，如骶骨定位的患者，不进行手术干预，根治性放疗和化疗可能更可取。
三级，治疗性研究。
