Lu S, Wang J, Hu Y
Orthopedic Department, General Hospital of PLA, Beijing.
Chin Med J (Engl). 1996 Jun;109(6):432-6.
To use intraoperative microwave heat for the treatment of tumor-bearing bone in situ for limb-salvage in primary malignant bone tumor.
Twenty-five patients with malignant bone tumor received surgical protocol for limb-salvage by wide exposure and intraoperative microwave heat treatment of tumor bone in situ. The tumor was localized at distal femur in 16 patients, proximal tibia in 5, shaft of femur in 2, and illia in 2.
The pathological diagnosis revealed osteosarcoma in 16 patients, parosteal osteosarcoma in 4, chondrosarcoma in 3, and leiomyosarcoma in 2. The stage of tumor was classified into IIB in 16 patients, IIA in 6, and IIIB in 3. The operative technique was wide exposure for tumor in soft tissues, protecting the surrounding normal tissue from heat injury by copper mesh, and heating tumor-bearing bone at 50 degrees C for 15 minutes. The patients were followed up from 4 to 180 months (mean, 63 months). The survival rate of 2, 5 and 10 years was 81.3%, 70.4%, and 53.8% respectively. The functional results were less than 50% in 4 patients, between 50% and 75% in 9, and more than 75% in 12, referred to the normal function of a normal limb. The complications consisted of infection in 4 patients, pathological fracture in 4, and separation of epiphysis in 1. Oncological results showed that local recurrences of tumor were in 4 patients, and 6 patients suffered from distant metastasis.
The treatment is an alternative to replacement by prosthesis or allograft bridging techniques.
采用术中微波热疗原位治疗原发性恶性骨肿瘤的瘤骨，以挽救肢体。
25例恶性骨肿瘤患者接受了通过广泛暴露和术中微波热疗原位治疗瘤骨来挽救肢体的手术方案。肿瘤位于股骨远端16例，胫骨近端5例，股骨干2例，髂骨2例。
病理诊断显示骨肉瘤16例，骨旁骨肉瘤4例，软骨肉瘤3例，平滑肌肉瘤2例。肿瘤分期为ⅡB期16例，ⅡA期6例，ⅢB期3例。手术技术为广泛暴露软组织中的肿瘤，用铜网保护周围正常组织免受热损伤，并在50℃加热瘤骨15分钟。对患者进行了4至180个月（平均63个月）的随访。2年、5年和10年生存率分别为81.3%、70.4%和53.8%。与正常肢体的正常功能相比，4例患者的功能结果小于50%，9例在50%至75%之间，12例大于75%。并发症包括4例感染，4例病理性骨折，1例骨骺分离。肿瘤学结果显示4例患者出现肿瘤局部复发，6例发生远处转移。
该治疗方法是假体置换或同种异体骨桥接技术的一种替代方法。
