CAJ | 학술논문

目的：总结多中心性骨肉瘤( multifocal osteosarcoma, MFOS )的治疗及预后。方法2010年3月至2014年12月，我院收治 MFOS 患者6例( A1、A2、A3、A4、B1、B2)，其中男4例，女2例。4例( A 组)在初诊时全身多处骨骼存在骨肉瘤病灶，2例( B 组)治疗过程中先后出现多处骨肉瘤病灶。术前新辅助化疗，术后继续化疗。6例中1例放弃治疗，其余5例均接受化疗，其中有4例在接受1～2次化疗后给予手术治疗。化疗方案为 MAPI 方案，1个周期的用药：第1～2天给予阿霉素60 mg / m2，1次/天；第3天给予顺铂100 mg / m2，1次/天；第14天给予甲氨蝶呤8～12 g / m2、长春新碱1.4 mg / m2，1次/天；第21～25天给予异环磷酰胺12.5 g / m2，1次/天。前、后 2次化疗间隔时间为3周。结果放弃治疗的1例( A1)存活5个月；1例( A4)发病至今4个月，仍在治疗中；其余 4例( A2、A3、B1、B2) 生存时间分别为19、6、13、18个月。结论MFOS 预后极差，经积极的化疗及手术干预，部分患者能延长生存期。
목적：총결다중심성골육류( multifocal osteosarcoma, MFOS )적치료급예후。방법2010년3월지2014년12월，아원수치 MFOS 환자6례( A1、A2、A3、A4、B1、B2)，기중남4례，녀2례。4례( A 조)재초진시전신다처골격존재골육류병조，2례( B 조)치료과정중선후출현다처골육류병조。술전신보조화료，술후계속화료。6례중1례방기치료，기여5례균접수화료，기중유4례재접수1～2차화료후급여수술치료。화료방안위 MAPI 방안，1개주기적용약：제1～2천급여아매소60 mg / m2，1차/천；제3천급여순박100 mg / m2，1차/천；제14천급여갑안접령8～12 g / m2、장춘신감1.4 mg / m2，1차/천；제21～25천급여이배린선알12.5 g / m2，1차/천。전、후 2차화료간격시간위3주。결과방기치료적1례( A1)존활5개월；1례( A4)발병지금4개월，잉재치료중；기여 4례( A2、A3、B1、B2) 생존시간분별위19、6、13、18개월。결론MFOS 예후겁차，경적겁적화료급수술간예，부분환자능연장생존기。
Objective To investigate the curative outcomes and prognosis of multifocal osteosarcoma ( MFOS ).Methods From March 2010 to December 2014, 6 patients with MFOS were adopted, including 4 males and 2 females. Four patients ( A1, A2, A3 and A4 ) were diagnosed as synchronous MFOS at the ifrst visit. Metachronous MFOS was noticed in the other 2 patients ( B1 and B2 ) during the treatment process. Neoadjuvant chemotherapy was performed preoperatively and chemotherapy postoperatively. One of the 6 patients gave up, and the other 5 patients received chemotherapy and surgery. Surgery was performed on 4 patients after 1-2 cycles of chemotherapy. The chemotherapy drugs used in these patients for each cycle included adriamycin ( 60 mg / m2 ) at the 1-2 day, cisplatinum ( 100 mg / m2 ) at the 3 day, methopterin ( 8-12 g / m2 ) and vincristine ( 1.4 mg / m2 ) at the 14 day and ifosfamide ( 12.5 g / m2 ) at the 21-25 day, once a day. The interval time was 3 weeks between the 1st and 2nd round of chemotherapy. Results The patient ( A1 ) who gave up the treatment died 5 months after the diagnosis. One patient ( A4 ) survived for nearly 4 months after the diagnosis, and was still under treatment. The survival time of the other 4 patients ( A2, A3, B1 and B2 ) was 19, 6, 13 and 18 months respectively.Conclusions The prognosis of the patients with MFOS is poor. To improve the prognosis of the patients with MFOS, aggressive chemotherapy and surgery are needed.