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新辅助化疗联合保肢手术治疗骨肉瘤的疗效及其对长期生活质量的影响

Efficacy of Neoadjuvant Chemotherapy plus Limb-Sparing Surgery for Osteosarcoma and Its Impact on Long-Term Quality of Life.

作者信息

Jing Shixia, Ding Fengling, Yuan Yinghong, An Jing, He Qiang

机构信息

Central Sterile Supply Department, Nanchong Central Hospital, Nanchong 637000, China.

Department of Orthopedics, Rizhao Central Hospital, Rizhao 276800, China.

出版信息

Evid Based Complement Alternat Med. 2022 Aug 8;2022:1693824. doi: 10.1155/2022/1693824. eCollection 2022.

Abstract

PURPOSE

To assess the efficacy of neoadjuvant chemotherapy plus limb-sparing surgery for osteosarcoma and its impact on long-term quality of life.

METHODS

Between August 2016 and December 2018, 90 patients with osteosarcoma treated in Nanchong Central Hospital were recruited and divided at a ratio of 1 : 1 to receive limb-sparing surgery (control group) or limb-sparing surgery plus neoadjuvant chemotherapy (study group) by random number table methods. The clinical endpoints were clinical efficacy and long-term quality of life.

RESULTS

Limb-sparing surgery plus neoadjuvant chemotherapy was associated with a significantly higher efficacy versus limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy resulted in a significantly higher Enneking score and a higher good function rating of patients versus limb-sparing surgery. The two groups showed a high but similar 1-year survival rate. Patients given limb-sparing surgery plus neoadjuvant chemotherapy showed significantly higher 2-year and 3-year survival and a longer mean survival versus those receiving limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy resulted in significantly higher scores of role emotional, mental health, physical function, and social function and a lower bodily pain score than limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy was associated with significantly lower fatigue, nausea and vomiting, dyspnea, constipation, and diarrhea scores and a significantly higher health status score versus monotherapy of limb-sparing surgery.

CONCLUSION

Neoadjuvant chemotherapy plus limb-sparing surgery improves the postoperative limb function and long-term quality of life of patients with osteosarcoma, which shows great potential for clinical promotion.

摘要

目的

评估新辅助化疗联合保肢手术治疗骨肉瘤的疗效及其对长期生活质量的影响。

方法

2016年8月至2018年12月,招募了90例在南充市中心医院接受治疗的骨肉瘤患者,采用随机数字表法按1∶1比例分为两组,分别接受保肢手术(对照组)或保肢手术联合新辅助化疗(研究组)。临床终点为临床疗效和长期生活质量。

结果

与单纯保肢手术相比,保肢手术联合新辅助化疗的疗效显著更高。与单纯保肢手术相比,保肢手术联合新辅助化疗使患者的Enneking评分显著更高,功能良好评级更高。两组的1年生存率均较高且相似。与单纯接受保肢手术的患者相比,接受保肢手术联合新辅助化疗的患者2年和3年生存率显著更高,平均生存期更长。与单纯保肢手术相比,保肢手术联合新辅助化疗使角色情绪、心理健康、身体功能和社会功能评分显著更高,身体疼痛评分更低。与单纯保肢手术治疗相比,保肢手术联合新辅助化疗的疲劳、恶心呕吐、呼吸困难、便秘和腹泻评分显著更低,健康状况评分显著更高。

结论

新辅助化疗联合保肢手术可改善骨肉瘤患者术后肢体功能和长期生活质量,具有很大的临床推广潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e10/9377866/5fc72014f263/ECAM2022-1693824.001.jpg

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