A Study On The Prognosis Of Children With Limb Osteosarcoma And Analysis Of Traditional Chinese Medicine Syndrome Types Of Aphthous Ulcer After Chemotherapy

Objective To explore the related factors that affect the clinical prognosis of children’s limb osteosarcoma,and analysis of Traditional Chinese Medicine Syndrome Types of aphthous ulcer after chemotherapy.Methods A retrospective analysis was made of the medical records of children(≤14 years)with limb osteosarcoma admitted to seven bone cancer treatment centers in China from June 2000 to October 2017,And children osteosarcoma patients with aphthous ulcer after chemotherapy in our hospital from July 2017 to October 2019.The general data,surgical staging and preoperative biopsy,number of chemotherapy,chemotherapy,surgical method,recurrence and metastasis,survival prognosis,TCM symptoms and signs(tongue coating and pulse)of children with aphthous ulcer in our hospital were recorded.A kaplan-meier method was used to plot survival curve and calculate survival rate.A log-rank analysis was used to determine the prognostic factors related to the survival rate.The Cox model multivariate analysis was used to identify independent prognostic factors.The methods of variance analysis andχ~2test were used to analyze TCM syndrome types.Results There were 73 males and 74 females among 147 patients.Children with osteosarcoma of the limb had a 3-and 5-year overall survival rates of 65%and 53%.Univariate analysis showed that standard chemotherapy,Enneking surgical stage,frequency of postoperative adjuvant chemotherapy,recurrence and metastasis were related factors affecting the survival and prognosis of children with limb osteosarcoma(p<0.05).However,gender,location,surgical method and whether methotrexate(MTX)was used in chemotherapy regimen were not related factors affecting the survival and prognosis of patients(P>0.05).Cox regression multivariate analysis showed that standard chemotherapy,recurrence and metastasis were independent factors affecting the survival and prognosis of children with limb osteosarcoma(p<0.05).Among 30 cases of osteosarcoma in children with aphthous ulcer after chemotherapy,17 were male and 13 were female.The age of illness was 4～14 years old.The main preoperative chemotherapy was wind heat with spleen syndrome(19 cases),Two times of postoperative chemotherapy,the main syndrome was heart fire inflammation(17 cases),4 times of postoperative chemotherapy,the main syndrome was asthenia and floating upward(20 cases).Conclusion Standard neoadjuvant chemotherapy and effective control of recurrence and metastasis can improve the survival rate of children with limb osteosarcoma.Non-standard chemotherapy and recurrence and metastasis seriously affect the prognosis of patients.Among the children with aphthous ulcer after chemotherapy,the distribution characteristics of medical syndrome type were correlated with gender,operation and times of chemotherapy.