论文部分内容阅读
在应用辅助化疗之前,骨肉瘤患者的预后劣,生存质量差。大多数患者可行截肢治疗,仅20%的病人得以在确诊后活逾5年。究其原因,绝大多数病人在原发肿瘤手术之际,体内已有了难以查觉的微小转移灶,因为常常术后6个月内便出现明显的转移灶。恶性肿瘤辅助化疗的概念从动物实验模型获得根据,即化疗给予仅有微小癌灶的实验动物远比瘤体已可发现时的治疗希望大。在人类小儿白血病和Wilm’s瘤患者,对大型的负荷能产生消退作用的化疗用量常可治愈肉眼不见的微小转移。既然已发现某些化疗药物能有效地对付可被测量的骨生肉瘤转移灶,人们自然对该瘤的辅助化疗进行了尝试,希图降低复发率。
Prior to the use of adjuvant chemotherapy, osteosarcoma patients had a poor prognosis and poor quality of life. Most patients are eligible for amputation, and only 20% of patients can survive more than 5 years after diagnosis. The reason is that the vast majority of patients have had small metastases that are difficult to detect when they are undergoing primary tumor surgery, because they often have significant metastases within 6 months of surgery. The concept of adjuvant chemotherapy for malignant tumors is based on the experimental animal model, that is, chemotherapy given to experimental animals with only small lesions is much more promising than treatment when the tumor is already detectable. In patients with human pediatric leukemia and Wilm’s tumors, chemotherapy doses that are capable of producing regressions for large loads can often cure macroscopic metastases that are not seen by the naked eye. Since it has been found that certain chemotherapeutic drugs can effectively cope with bone metastases that can be measured, it has naturally been attempted to adjuvant chemotherapy for this tumor in an attempt to reduce the recurrence rate.