Takeyama S, Tateishi A, Higaki S
Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1399-404.
In our Department since 1960 isolation perfusion chemotherapy has been performed as a preoperative procedure combined with surgery in 134 patients with osteosarcoma of the extremity. In this paper, the significance of isolation perfusion chemotherapy was presented. The cumulative 5-year survival rate of 114 perfused patients was 42.7%, while that of 41 non-perfused patients before 1960 was 17.1%. Of the 114 patients 102 underwent amputation and 12 had limb salvage surgery. The cumulative 5-year survival rate of the 9 patients who have received limb salvage surgery since 1978 is 68%. Eleven patients who received preoperative aggressive chemotherapy including isolation perfusion chemotherapy showed a 91% clinical and radiological response to the drug. The tumor was microscopically analyzed and the ratio of necrotic to viable tumor cells was calculated. The degree of tumor necrosis was classified as excellent (greater than or equal to 95%), good (80-94%), fair (50-79%) and poor (less than 50%). The response in 22 patients who received preoperative aggressive chemotherapy using adriamycin, methotrexate and cis-platinum including the use of isolation perfusion was excellent in 41%, good in 36%, fair in 14% and poor in 9%. We believe that preoperative isolation perfusion chemotherapy is an effective procedure for limb salvage surgery.
自1960年起，在我们科室，134例肢体骨肉瘤患者接受了术前隔离灌注化疗并联合手术。本文阐述了隔离灌注化疗的意义。114例接受灌注化疗患者的5年累积生存率为42.7%，而1960年前41例未接受灌注化疗患者的5年累积生存率为17.1%。114例患者中，102例行截肢术，12例行保肢手术。1978年以来接受保肢手术的9例患者的5年累积生存率为68%。11例接受包括隔离灌注化疗在内的术前强化化疗的患者对药物的临床和影像学反应率为91%。对肿瘤进行显微镜分析并计算坏死肿瘤细胞与存活肿瘤细胞的比例。肿瘤坏死程度分为优（大于或等于95%）、良（80 - 94%）、中（50 - 79%）和差（小于50%）。22例接受包括使用隔离灌注在内的术前强化化疗（使用阿霉素、甲氨蝶呤和顺铂）的患者中，反应为优的占41%，良的占36%，中的占14%，差的占9%。我们认为术前隔离灌注化疗是保肢手术的有效方法。
