소아 골육종에서 동맥내 Cisplatin항암치료의 성적
Treatment Result of Pediatric Osteosarcoma with Intraarterial Cisplatin
대한암학회지 1998년 30권 1호 p.169 ~ 177
소속 상세정보
최형수
강형진/이준아/한효정/박현진/성기웅/유은선/김우선/신희영
KMID : 0360319980300010169
Abstract
결론
수술전 동맥내 cisplatin 항암치료를 받은 골육 종환자의 5년 생존율은 62.1%였고 사지구
제술이 가능했던 경우는 전체의 75%였다 동맥내 cisplatin은 치료의 시행이 비교적 용이하
고 치료에 대한 반응도 양호한 방법으로서 독성을 줄이기 위하여 적절한 진토제의 사용과
전해질 불균형에 대한 교정 및 pulsatile infusion pump의 도입이 적극적으로 고려되어야 할
것으로 생각된다 폐전이에 대해서는 동맥내 cisplatin 단독으로는 그 치료효과가 충분하지
않은 것으로 보이며, doxorubicin 정맥주입과의 병합요법을 통해 폐전이를 효과적으로 치료
함으로써 앞으로 생존율을 더욱 향상시킬 수 있을 것으로 기대된다.
Purpose : This study was performed to determine the outcome after treatment of
osteosarcoma with intraarterial cisplatin as a preoperative chemotherapy regimen.
Materials and Methods : Twenty five patients with extremity osteosarcoma were
treated with intraarterial cisplatin at Seoul National University Children's Hospital from
January 1987 to April 1996. The dose of cisplatin was 130 ㎎/㎡ and three to six
courses were repeated two- to three-week intervals Systemic doxorubicin was added to
six of these patients. This was followed by surgical resection(limb salvage or
amputation) and postoperative adjuvant chemotherapy.
Results : Limb-salvage was possible in twenty of these twenty five patients.
Pulmonary metastasis was present in five patients at diagnosis and developed later in
three patients. In six patients treated with systemic doxorubicin, pulmonary metastasis
was absent at diagnosis and during follow-up period. Local recurrence after limb
salvage was occurred in one patient and treated with amputation and systemic
chemotherapy Seven patients died from pulmonary metastasis and one from unknown
cause. The follow-up duration of these patients was three to eighty eight
months(median twenty two months) and the overall five-year survival and event free
survival rate were 62.1% and 57.5%, respectively.
Conclusion: These data demonstrate that intraarterial cisplatin can be used as an
effective regimen preoperatively for pediatric patients with extremity osteosarcoma. The
combined use of systemic doxorubicin is expected to improve survival in patients with
pulmonary metastasis.
키워드
Osteosarcoma; Intraarterial cisplatin; Survival rate;
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