Furuse K, Maeyama I, Morimoto K, Orito T, Okuno M
Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1392-8.
The rationale of preoperative chemotherapy for osteosarcoma requires: eradication of microscopic metastatic foci which have already occurred in many patients with osteosarcoma, determination of a more effective form of postoperative adjuvant chemotherapy and easier and safer limb-salvage procedures through clearer marginal definition with reduction of primary lesions. In this paper, chemotherapeutic effects on the 5-year survival rate were analyzed for 49 patients with primary non-metastatic osteosarcoma of the extremities treated with radical surgery. The efficacy of preoperative chemotherapy was assessed in 11 cases of osteosarcomas treated with systemic chemotherapy as a preliminary study. As to the 5-year cumulative survival rate, the systemic group (20 cases) showed a level of 56.7%, which was significantly higher (p less than 0.05) than the figure of 13.8% in a historical retrospective group (29 cases). In assessing the effective tumor response to preoperative chemotherapy, a close correlation between the tumor necrotic ratio and the ratio of decrease of serum alkaline phosphatase was revealed. Seven (63.6%) of 11 cases showed correlation of the tumor necrotic ratio with the ratio of decrease of serum alkaline phosphatase. The tumor necrotic ratios calculated were relatively definite (50-60%) in the CDDP group (3 cases), varied (10-70%) in the HDMTX group (4 cases), and low (less than 40%) in the ADR group (4 cases), regarded as a control group in further studies.
消灭许多骨肉瘤患者体内已经出现的微小转移灶；确定更有效的术后辅助化疗形式；通过更清晰的边缘界定缩小原发灶，从而使保肢手术更简便、安全。本文分析了49例接受根治性手术的原发性肢体非转移性骨肉瘤患者化疗对其5年生存率的影响。作为初步研究，对11例接受全身化疗的骨肉瘤患者评估了术前化疗的疗效。关于5年累积生存率，全身化疗组（20例）为56.7%，显著高于历史回顾组（29例）的13.8%（p<0.05）。在评估术前化疗的有效肿瘤反应时，发现肿瘤坏死率与血清碱性磷酸酶降低率之间密切相关。11例中有7例（63.6%）的肿瘤坏死率与血清碱性磷酸酶降低率相关。在进一步研究中作为对照组的ADR组（4例）计算出的肿瘤坏死率较低（低于40%），HDMTX组（4例）的肿瘤坏死率各异（10%-70%），CDDP组（3例）的肿瘤坏死率相对确定（50%-60%）。
