Bacci G, Picci P, Gitelis S, Borghi A, Campanacci M
Cancer. 1982 Apr 15;49(8):1561-70. doi: 10.1002/1097-0142(19820415)49:8<1561::aid-cncr2820490808>3.0.co;2-k.
Eighty consecutive patients with localized Ewing's tumor treated with adjuvant chemotherapy for two years plus local tumor control were retrospectively reviewed. Adjuvant chemotherapy protocol was constant for all patients, but local treatment consisted of amputation, resection (complete or incomplete) plus radiotherapy, or radiotherapy alone. The follow-up ranged from 21--101 months (mean = 50 months). The mortality rate and incidence of metastasis were significantly lower than in a comparable group of 83 patients previously treated by radiotherapy, or surgery plus radiotherapy but without chemotherapy. The percentage of local recurrence was not significantly different between the two groups. Of the patients treated with adjuvant chemotherapy, the percentage of local recurrence and metastases was much lower when the primary lesion was located in the extremities and when this lesion was treated by conservative surgery followed by irradiation. This was also true when the resection was not complete. Little discrepancy in functional results was observed using either resection plus radiotherapy or radiotherapy alone. The above data suggest that in treating Ewing's sarcoma, conservative surgery, even incomplete, can play an important role when associated with radiotherapy and adjuvant chemotherapy.
对80例接受辅助化疗两年并结合局部肿瘤控制的局限性尤因肉瘤患者进行了回顾性研究。所有患者的辅助化疗方案均一致，但局部治疗包括截肢、切除（完全或不完全）加放疗或单纯放疗。随访时间为21至101个月（平均50个月）。死亡率和转移发生率显著低于之前一组83例仅接受放疗或手术加放疗但未接受化疗的患者。两组之间局部复发率无显著差异。在接受辅助化疗的患者中，当原发灶位于四肢且采用保守手术加放疗治疗时，局部复发和转移的百分比要低得多。即使切除不完全时也是如此。采用切除加放疗或单纯放疗时，功能结果差异不大。上述数据表明，在治疗尤因肉瘤时，保守手术即使不完全，与放疗和辅助化疗联合应用时也可发挥重要作用。
