Takada N, Hodaka E, Umeda T, Hayashi H
Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1405-11.
Preoperative radiotherapy and systemic chemotherapy are effective for reducing the size of a tumor and rendering it resectable. The results achieved with systemic chemotherapy are ultimately reflected in improved survival. Moreover, limb-saving procedure in the treatment of osteosarcoma has become possible with rationality in carefully selected patients. Since 1975, 38 patients with osteosarcoma within an age range of 5 to 56 years, (average 17.9 years) have been treated by fast neutron radiotherapy, systemic chemotherapy and limb-salvage surgery. Twenty-two of these 38 patients underwent en bloc resection of the femur, eight resection of the proximal tibia and five resection of the proximal humerus. Only one of the 38 patients had evidence of local tumor recurrence and overall, 31 patients are currently alive without distant metastasis after 9 to 120 months follow-up. Preoperative fast neutron radiotherapy was employed and it was suggested that fast neutrons had a higher relative biological effectiveness and a greater therapeutic gain factor in comparison with X-rays. Fast neutron radiotherapy thus seems capable of playing a significant role in the treatment of osteosarcoma and is specifically useful for preservation of the affected limb.
术前放疗和全身化疗对于缩小肿瘤大小并使其可切除有效。全身化疗所取得的结果最终体现在生存率的提高上。此外，对于精心挑选的骨肉瘤患者，合理实施保肢手术已成为可能。自1975年以来，38例年龄在5至56岁（平均17.9岁）的骨肉瘤患者接受了快中子放疗、全身化疗和保肢手术。这38例患者中，22例行股骨整块切除，8例行胫骨近端切除，5例行肱骨近端切除。38例患者中只有1例有局部肿瘤复发迹象，总体而言，31例患者在9至120个月的随访后目前仍存活且无远处转移。采用了术前快中子放疗，并且有人提出，与X射线相比，快中子具有更高的相对生物效应和更大的治疗增益因子。因此，快中子放疗似乎能够在骨肉瘤治疗中发挥重要作用，尤其有助于保留患肢。
