骨肉瘤化疗的历史和现状
范顺武,杨迪生,陶惠民,叶招明
摘要(Abstract):
目的 :文献复习骨肉瘤化疗的历史和目前存在的基本问题。方法 :结合文献对骨肉瘤化疗的历史背景、辅助化疗、新辅助化疗、术前化疗的给药途径和目前存在的问题和展望等几个方面进行讨论。结果 :2 0余年的临床实践证明化疗是目前提高骨肉瘤生存率的最主要手段 ,但在积极的治疗过程中仍有 40 %左右的病例治疗失败 ,其主要原因可能与骨肉瘤细胞对化疗药物的耐药有关。结论 :提高骨肉瘤病人对化疗的敏感性和增加化疗剂量强度可能是目前进一步提高骨肉瘤治愈率的主要措施。
关键词(KeyWords): 新辅助化疗;骨肉瘤;多药耐药;剂量强度
基金项目(Foundation):
作者(Author): 范顺武,杨迪生,陶惠民,叶招明
Email:
DOI:
参考文献(References):
- 〔1〕 RosenG ,TanC ,SanmaneechaiA ,etal.Therationaleformultipledrugchemotherapyinthetreatmentofosteogenicsarcoma.Cancer,1 975 ,35(supple) :936~ 945 .
- 〔2〕 EvansAE .MitomycinC .CancerChemotherRep ,1 961 ,1 4 :1~ 9.
- 〔3〕 SullivanMP ,SutowWW ,TaylorG .L phenylalaninemustardasatreat mentformetastaticosteogenicsarcomainchildren .JPediatr,1 963 ,63:2 2 7~ 2 37.
- 〔4〕 FriedmanMA ,CarterSK .Thetherapyofosteogenicsarcoma Currentsta tusandthoughtsforthefuture .JSurgOncol,1 972 ,4:482~ 51 0 .
- 〔5〕 CotesEP ,HollandJE ,WangJJ.Doxorubicinindisseminatedosteosarco ma.JAMA ,1 972 ,2 2 1 :1 1 32~ 1 1 38.
- 〔6〕 JaffeN .Recentadvanceinthechemotherapyofmetastaticosteogenicsar coma.Cancer,1 972 ,30 :1 62 7~ 1 631 .
- 〔7〕 RosenG ,SuwansirikulS,KwonC ,etal.High dosemethotrexatewithcit rovorumfactorrescue ,andadriamycininchildhoodosteogenicsarcoma .Cancer,1 974,33 :1 1 51~ 1 1 63 .
- 〔8〕 RosenG ,TanC ,ExelbyP ,etal.Vincristine(VCR) ,high dosemethotrex ate(HDMTX)withcitrovorumfactor(CF)rescue ,cyclophamide(CY) ,andadriamycin (ADM )cyclictherapyfollowingsurgeryinchildhoodos teogenicsarcoma.ProcAmAssocCancerRes,1 974(abstr) ,1 5 :1 72 .
- 〔9〕 JaffeN ,FreiE ,TraggisD ,etal.Adjuvantmethotrexateandcitrovorumfactortreatmentofosteogenicsarcoma .NEnglJMed,1 974,2 91 :994~997.
- 〔1 0〕BacciG ,PaganiP ,DonatiU .Adjuvantchemotherapyassociatedwithsurgeryinthetreatmentofosteosarcoma .ItaliJOrthopTrauma ,1 976 ,2 :363~ 374.
- 〔1 1〕PicciP ,FerrariS,BacciG ,etal.Treatmentrecommendationforosteosar comaandsoft tissuesarcoma.Drug ,1 994,47:82~ 92 .
- 〔1 2〕RosenG ,MarcoveRC ,CaparrosB ,etal.Primaryosteogenicsarcoma,Therationaleforpreoperativechemotherapyanddelayedsurgery.Cancer,1 979,43 :2 1 63~ 2 1 77.
- 〔1 3〕RosenG ,CaparrosB ,HuvosAG ,etal.Preoperativechemotherapyforos teogenicsarcoma:selectionofposteoperativeadjuvantchemotherapybasedontheresponseofprimarytumortopreoperativechemotherapy.Cancer,1 982 ,49:1 2 2 1~ 1 2 30 .
- 〔1 4〕RosenG .Preoperative(neoadjuvant)chemotherapyforosteogenicsarcoma :atheyearsexperience .Othopeadics,1 985 ,8:659~ 664 .
- 〔1 5〕JaffeN ,RobertsonR ,AyalaA ,etal.Comparisonofintra arterialcisdi amminochloro platinumⅡwithhigndosemethotrexateandcistrovorumfactorrescueinthetreatmentofprimaryosteogenicsarcoma .JClinOncol,1 985,3 :1 1 0 1~ 1 1 0 4 .
- 〔1 6〕BramwellVH ,BurgeraM ,SneathR ,etal.Comparisonoftwoshortinten siveadjuvantchemotherapyregimensinoperableosteosarcomaoflimbsinchildrenandyoungadults:thefirststudyoftheeuropeanosteosarcomain tergroup .JClinOncol,1 992 ,1 0 :1 579~ 1 591 .
- 〔1 7〕UchidaA ,MyouiA ,ArakiN ,etal.Neoadjuvantchemotherapyforpedi atricosteosarcomapatients.Cancer,1 997,79:41 1~ 41 5 .
- 〔1 8〕JaffeN ,PaedD ,FreiE ,etal.Weekly high dosemithotrexate citrovorumfactorinosteogenicsarcoma.Presurgicaltreatmentofprimarytumorandofovertpulmonarymetadstases .Cancer,1 977,39:45~ 50 .
- 〔1 9〕ProvisonAJ ,EttingerLJ,Nachman ,JB ,etal.Treatmentofnonmetastaticosteosarcomaoftheextremitywithpreoperativeandpostoperativechemotherapy:Areportfromethechildren’scancergroup .JClinOncol,1 977,1 5 :76~ 84.
- 〔2 0〕MeyersPA ,HellerG ,HealeyJ,etal.Chemotherapyfornon metastaticos teogenicsarcoma:TheMemorialSloan KetteringExperience.JClinOncol,1 992 ,1 0 :5~ 1 5 .
- 〔2 1〕BacciG ,PicciP ,RuggieriP ,etal.Primarychemotherapyanddelayedsurgery(neoadjuvantchemotherapy)forosteosarcomaoftheextremities.TheRizzoli’sexperiencein 1 2 7patientstreatedpreoperativelywithmethotrex ateiv (highvsmoderatedose)andcisplatinumia .Cancer,1 990 ,65 :2 539~ 2 553 .
- 〔2 2〕PicciP ,BacciG ,FerrariS ,etal.Localrecurrenceafterlimbsalvagepro ceduresforosteosarcoma:Correlationwithmarginsandchemotherapyin ducednecrosis.JBoneJointSurg(Am) ,1 993 ,57(supp1 2 ) :2 1 1~ 2 1 6 .
- 〔2 3〕GuchelaarHJ,HoekstraHJ,DeVriesEGE ,etal.Cisplatinandplatinumpharmacokineticsduringhyperthermicisolatedlimbperfusionforhumantumorsoftheextremities,BrJCancer,1 992 ,65 :898~ 90 2 .
- 〔2 4〕夏贤良 ,杨迪生 ,范顺武 ,等 .下肢骨肉瘤高温隔离灌注化疗初步报告 .中华骨科杂志 ,1 994,1 4 :645~ 648.
- 〔2 5〕杨迪生 ,范顺武 ,陶惠民 ,等 .高温隔离灌注化疗在下肢骨与软组织肉瘤保肢治疗中的价值与限度 .中国矫形外科杂志 ,1 994,1 4 :347~ 349.
- 〔2 6〕GoldsteinLJ.Clinicalreversalofdrug(Revirw) .CurrProbinCancer,1 995 ,1 9:65~ 1 2 4 .
- 〔2 7〕LingV ,CharlesF ,KetteringP .P glycoproteinandresistancetoanticancerdrugs(review) .Cancer,1 992 ,69:2 60 3~ 2 60 9.
- 〔2 8〕LumBL ,FisherGA ,BrophyNA .Clinicaltrialofmodulationofmultidrugresistance .pharmacokineticandpharmacodynamicconsiderations.(re view) .Cancer,1 993 ,72 (suppl1 1 ) 3 50 2~ 3 51 4 .
- 〔2 9〕BrachDPA ,MassaraFM ,BesenzonL ,etal.Treatmentofmetastaticos teosarcomawithverapamil,cyclosporineandchemotherapy.Acasereport.ItaliMinervaPediatr,1 995 ,47:1 4 7~ 1 51 .