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목적 : 골육종환자에서 cisplatin과 adriamycin을 사 용한 술전 화학요법을 시행하여 반응율 및 생존율을 알 아보고자 하였다. 방법 : 골육종 환자 24명 중 보조요법만 시행한 4명의 환자를 제외한 20명의 환자를 대상으로 술전 화학요법 과 술후 화학요법을 시행한 14명의 환자군을 A군으로 하고 술후에 화학요법을 시행한 6명의 환자군을 B군으 로 하였다. A군 중 12명은 사지구제술을 시행하고 2명은 진행하여 사지절단술을 시행하였고 B군 중 사지외 병소 가 있는 3명은 광범위절제술, 사지에 병소가 있는 3명은 사지절단술을 시행하였다. 결과 : 평균연령은 27.5세이었고, 평균추적기간은 39.3개월이었다. Kaplan-Meier법에 의한 1년, 3년 평균 생존율은 A군은 각각 100%, 85%이었으며 B군은 각각 100%, 75%였다(p>0.05). 환자의 병리학적 반응도는 술 전 화학요법을 시행한 A군에서 평가되었는데 90% 이상 의 조직학적 괴사(Huvos Grade III, IV)가 9명, 90% 미 만의 조직학적 괴사(Huvos Grade I, II)가 5명에서 나타 났고, 이들 환자의 평균 생존기간은 Huvos Grade III, IV 군은 82개월, Grade I, II군은 25개월이었고, 1년 평균 생 존율은 각각 100%, 100%, 3년 평균생존율은 87%, 80% 로 통계학적으로 유의성은 없었다(p>0.05).


Background : Adjuvant chemotherapy is the most accepted treatment for localized osteosarcoma. We studied the effectiveness of preoperative cisplatin and adriamycin combination chemotherapy in non-metastatic osteosarcoma. Methods : Twenty four cases of patient with osteosarcoma were divided into two groups except four patients treated only conservatively. Group A (14 patients) received chemotherapy before operation and Group B (6 patients) received chemotherapy after operation. The chemotherapy regimen consisted of cisplatin (120 mg/m2 on day 1) and adriamycin (adriamycin 25 mg/m2 on days 2 to 4). Results : The average age of the 20 patients was 27.5 years and the median follow-up duration was 39.3 months. 12 patients of group A were treated with limb-salvage operation and 2 patients with amputation because of tumor growing. According to Kaplan-Meier's plot, one year, three year overall survival rate were 100%, 85% in Group A and 100%, 75% in Group B. Histologic responses were assessed in patients received preoperative chemotherapy. Tumor necrosis over 90% is noted in 9 patients, under 90% necrosis is noted 5 patients. Their mean survival was 82 months and 25 months, respectively (p>0.05). Conclusion : Adjuvant chemotherapy with cisplatin and adriamycin was feasible in non-metastatic osteosarcoma and clinically significant adverse effect was neutropenia.(Korean J Med 65:59-65, 2003)


Background : Adjuvant chemotherapy is the most accepted treatment for localized osteosarcoma. We studied the effectiveness of preoperative cisplatin and adriamycin combination chemotherapy in non-metastatic osteosarcoma. Methods : Twenty four cases of patient with osteosarcoma were divided into two groups except four patients treated only conservatively. Group A (14 patients) received chemotherapy before operation and Group B (6 patients) received chemotherapy after operation. The chemotherapy regimen consisted of cisplatin (120 mg/m2 on day 1) and adriamycin (adriamycin 25 mg/m2 on days 2 to 4). Results : The average age of the 20 patients was 27.5 years and the median follow-up duration was 39.3 months. 12 patients of group A were treated with limb-salvage operation and 2 patients with amputation because of tumor growing. According to Kaplan-Meier's plot, one year, three year overall survival rate were 100%, 85% in Group A and 100%, 75% in Group B. Histologic responses were assessed in patients received preoperative chemotherapy. Tumor necrosis over 90% is noted in 9 patients, under 90% necrosis is noted 5 patients. Their mean survival was 82 months and 25 months, respectively (p>0.05). Conclusion : Adjuvant chemotherapy with cisplatin and adriamycin was feasible in non-metastatic osteosarcoma and clinically significant adverse effect was neutropenia.(Korean J Med 65:59-65, 2003)