Chemotherapy Extraskeletal osteosarcoma Radiation therapy Radiotherapy Soft-tissue osteosarcoma
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摘要

PURPOSE:The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival.
PATIENTS AND METHODS:Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan-Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed.
RESULTS:370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%-62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26-0.80], p = 0.01).
CONCLUSION:Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.

译文

目的: 化疗 (CT) 和放疗 (RT) 在处理骨外型骨肉瘤 (ESOS) 中的作用仍有争议。我们检查了 ESOS 患者的疾病结局,并研究了 CT/RT 与复发和生存之间的关系。
患者和方法: 对 25 个国际肉瘤中心的回顾性调查确定了 1971年至 2016年接受 ESOS 治疗的 ≥ 18 岁患者。收集患者/肿瘤特征、治疗、局部/全身复发和生存数据。进行 Kaplan-Meier 生存和 Cox 比例风险回归和累积发生率竞争风险分析。
结果: 370 例明确接受手术治疗的局限性 ESOS 患者主要表现为深肿瘤 (n = 294,80%)。122 名患者单独接受了手术切除,96 名 (26%) 同时接受了 CT 、 70 名 (19%) RT 和 82 名 (22%) 两种佐剂。局限性 ESOS 患者的五年生存率为 56% (95% CI 51%-62%)。几乎一半的患者 (n = 173,47%) 出现复发: 局部 9% (35/370),远处 28% (102/370) 或两者均为 10% (36/370)。考虑到死亡是一个竞争事件,接受 CT 、 RT 或两者都接受的患者在局部或全身复发的累积发生率上没有显著差异 (局部 p = 0.50, 全身性 p = 0.69)。多元回归 Cox 分析显示 RT 和局部复发减少之间存在显著关联 (HR 0.46 [95% CI 0.26-0.80],p = 0.01)。
结论: 尽管 RT 的使用显著降低了局部复发,但 CT 并没有降低全身复发的风险,而且 CT 、 nor RT 或两者均与局部 ESOS 患者的生存改善相关。我们的结果不支持使用 CT; 然而,辅助 RT 在局部可切除的 eso 患者中显示出益处。

Osteosarcoma

儿科 恶性肿瘤 临床研究术语
概述  :  

骨肉瘤是起源于间叶组织的恶性肿瘤,以能产生骨样组织的梭形基质细胞为特征。经典型骨肉瘤是原发于髓腔内的高度恶性肿瘤,肿瘤细胞产生骨样组织,可能是极少量。流行病学经典型骨肉瘤占所有骨肉瘤的80%,主要发生于儿童和青少年,中位发病年龄为 20 岁。常见发病部位是股骨远端和胫骨近端,首发症状常为疼痛及肿胀,最常见的转移方式是血行转移至肺脏。诊断影像学检查:(1)骨内始发骨破坏;(2)可破坏骨皮质;(3)可在骨外形成软组织肿块;(4)可伴有骨膜反应;(5)病变基质可为成骨、溶骨或混合;(6)病变局部

osteosarcoma 英 /,ɒstɪəʊsɑː'kəʊmə/ 美 /,ɑstiosɑr'komə/

释    义   n. [肿瘤] 骨肉瘤

例    句   Osteosarcoma is one of the commonest primary malignant tumors of bone. It metastasizes fast, and has a high death rate. 骨肉瘤是原发于骨的肿瘤中最常见的一类恶性肿瘤,转移快,死亡率高。

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