Tian Dawei, Feng Kun, Wu Xiaobao, Gao Chao, Hu Lixin
Department of Orthopedics, Sinopharm Dongfeng General Hospital of Hubei University of Medicine, Shiyan 442000, Hubei, China.
Department of Postgraduate Training Base, Sinopharm Dongfeng General Hospital of Jinzhou Medical University and Hubei University of Medicine, Shiyan 442000, Hubei, China.
Evid Based Complement Alternat Med. 2022 Aug 25;2022:6510429. doi: 10.1155/2022/6510429. eCollection 2022.
To analyse the efficacy of high-dose methotrexate + adriamycin + cisplatin (HD-MTX + ADR + PDD, MAP) regimens applied to osteosarcoma and the pretreatment and resolution of chemotherapeutic reactions.
The clinical data of 21 patients with osteosarcoma in our hospital from January 2015 to January 2018 were retrospectively analysed. All patients were treated with the MAP protocol, 21 days for 1 cycle, and treated with artificial joint replacement or amputation after 3∼4 cycles of treatment. The tumour tissue necrosis rate, limb preservation success rate after treatment, and chemotherapy response during chemotherapy were counted and analysed for all patients. A local recurrence rate, a distant metastasis rate, and an overall survival rate were recorded during the 3-year follow-up period.
After treatment, the percentage of tumour tissue necrosis ≥90% was 85.71% (18/21) and the percentage of successful limb preservation was 57.14% (12/21) in 21 patients with osteosarcoma. During chemotherapy, all 21 patients with osteosarcoma experienced various degrees of chemotherapy reactions, mainly bone marrow suppression of 100% (21/21), gastrointestinal reactions of 100% (21/21), liver function impairment of 66.67% (14/21), and cardiotoxicity of 52.38% (11/21), all of which improved and completed treatment after treatment. During the 3-year follow-up period, the 21 patients with osteosarcoma had a local recurrence rate of 9.52% (2/21), a distant metastasis rate of 28.57% (6/21), and an overall survival rate of 80.95% (17/21).
With stringent protection and relief measures, patients with osteosarcoma treated with the MAP regimen have promising near-term outcomes, with high survival rates over 3 years and tolerable chemotherapy responses. The clinical trial is registered under L2015093.
分析大剂量甲氨蝶呤+阿霉素+顺铂（HD-MTX+ADR+PDD，MAP）方案应用于骨肉瘤的疗效以及化疗反应的预处理和缓解情况。
回顾性分析我院2015年1月至2018年1月收治的21例骨肉瘤患者的临床资料。所有患者均采用MAP方案治疗，21天为1个周期，治疗3～4个周期后行人工关节置换或截肢手术。统计分析所有患者的肿瘤组织坏死率、治疗后肢体保留成功率及化疗期间的化疗反应。记录3年随访期内的局部复发率、远处转移率及总生存率。
21例骨肉瘤患者治疗后肿瘤组织坏死率≥90%的比例为85.71%（18/21），肢体保留成功比例为57.14%（12/21）。化疗期间，21例骨肉瘤患者均出现不同程度的化疗反应，主要为骨髓抑制100%（21/21）、胃肠道反应100%（21/21）、肝功能损害66.67%（14/21）、心脏毒性52.38%（11/21），经治疗后均改善并完成治疗。3年随访期内，21例骨肉瘤患者局部复发率为9.52%（2/21），远处转移率为28.57%（6/21），总生存率为80.95%（17/21）。
通过严格的保护和缓解措施，采用MAP方案治疗的骨肉瘤患者近期疗效良好，3年生存率高，化疗反应可耐受。该临床试验已在L201509编号下注册。
