ABSTRACT
Polyetheretherketone (PEEK) as a new type of thermoplastic engineering plastic, has good biological activity, elastic modulus close to human cortical bone and radiation permeability, and has been widely used in medical field. This study aims to explore the safety and clinical efficacy of using 3D printing personalized PEEK materials to repaire scapular bone defects after bone tumor resection. A total of 6 patients who underwent the implantation of 3D printed PEEK scapular prosthesis from January 2020 to December 2021 in Yunnan Cancer Hospital were retrospectively analyzed. There were 3 males and 3 females, with age ranged from 14 to 52 years. There were 1 case of synovial sarcoma, 1 of Ewing's sarcoma, and 4 of chondrosarcoma. PEEK prosthesis was designed and fabricated based on CT data before surgery. Tumor resection and prosthesis replacement were performed under the premise of ensuring safe surgical boundaries, including 2 cases of total scapular prosthesis replacement and 4 cases of partial scapular prosthesis replacement. The operation time was 90-170 min, and the intraoperative blood loss was 100-400 ml. All 6 patients received satisfactory follow-up, with a tumor progression free survival time of 16-28 months. No tumor recurrence or metastasis was observed, and all patients survived tumor free. At last follow-up, the Constant-Murley shoulder joint score was a minimum of 62 points and a maximum of 68 points. The Japanese Orthopaedic Association's shoulder joint score was 63 points minimum and 78 points maximum. Computer-aided design 3D printing PEEK material prosthesis has certain advantages in the treatment of scapular tumor limb salvage. It has light weight, well adapted, relatively simple installation, good histocompatibility, and can obtain a better appearance and function of the shoulder joint after operation. It can become one of the options for limb salvage treatment of scapular tumor.
ABSTRACT
To observe the efficacy and safety of apatinib in the treatment of advanced bone and soft tissue sarcoma, and to analyze the possible related factors affecting the progression-free survival (PFS) of patients. Methods: Twenty-one patients with ad-vanced bone and soft tissue sarcoma admitted to the Department of Orthopaedics, Yunnan Cancer Hospital from June 2017 to Sep-tember 2018, were treated with apatinib tablets. The main efficacy index was progression free survival (PFS), and the secondary effica-cy index was overall survival (OS). Clinical efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) 1.1, and overall response rate (ORR), disease control rate (DCR), and safety were olserved according to the National Cancer Institute (NCI) 4.0 standard. Results: All of the 21 patients were followed up. At the last follow-up time point, March 31st, 2019, there were no CR, 2 patients (9.5%) with PR, 7 patients with SD (33.3%), and 12 patients with PD (57.1%). The ORR was 9.5%, the DCR was 42.8%, the medi-an PFS was 8 months, and the median OS was 14 months. The patient's gender, age, ECOG score, tissue source, surgery, or chemother-apy had no statistically significant effect on PFS (P>0.05). Only the history of radiotherapy before taking apatinib was a factor for pa-tients with PFS. The effect was statistically significant (P<0.05), and patients with a history of radiotherapy had a lower PFS than pa-tients without a history of radiotherapy. The adverse reactions of gradeⅢand above had hand-foot syndrome (14.3%), pneumotho-rax (14.3%) and anemia (4.8%). Conclusions: Apatinib has a certain effect for advanced bone and soft tissue sarcoma. The adverse re-actions are generally predictable, controllable and reversible. Apatinib can be a choice for patients with advanced bone and soft tissue sarcoma with good treatment adherence and no other treatment options.
ABSTRACT
ObjectiveTo evaluate temporary balloon occlusion of the abdominal aorta in high-order position sacral tumor surgical operation as a useful adjuvant technique.MethodsReviewed 79 cases of patients from 2005 to 2015 treated in our department and the diagnosis of high-order position sacral tumor. Temporary balloon occlusion of abdominal aorta was used in 50 patients(male 29,female 21)during the sacral tumors surgical operations. The other 29 patients(male 18,female 11)with sacral tumors who received the non-temporary balloon occlusion therapy were used as control group. The statistical differences of the whole surgery time,the blood loss during the surgery,the happening of the postoperative deep vein thrombosis,the time of the postoperative extubation were analyzed. ResultsThe differences were statistically significant(P<0.001)in the whole surgery time of balloon occlusion group(146.36±29.38)min vs non-balloon occlusion group(206.03±125.93)min,the blood loss of balloon occlusion group(1610.70±491.14)ml vs non-balloon occlusion group(2658.62±562.213)mL, and the time of the postoperative extubation of balloon occlusion group(6.60±2.76)d vs non-balloon occlusion group(12.52±2.86)d. However,there was not significant difference of the happening of the postoperative deep vein thrombosis between balloon occlusion group and non- balloon occlusion group. ConclusionTemporary balloon occlusion of abdominal aorta is effective and reliable. It significantly reduced the time of operations,the loss of blood,mean days in hospital,effusion of post-operation and recurrence rate. It makes the operation of sacral tumors much more safer than before and is a technique worthy of popularizing.