摘要
目的探讨恶性骨巨细胞瘤的治疗方法,为提高生存率、降低复发率和转移率提供参考依据。方法选择2001年1月至2012年12月诊断明确并成功随访的恶性骨巨细胞瘤患者6例,男3例,女3例,平均年龄28.8岁,4例既往有良性骨巨细胞瘤史。3例患者接受根治性手术,1例接受病灶刮除+肿瘤细胞灭活+植骨内固定术,1例接受高强度聚焦超声治疗,1例接受化疗+对症支持治疗。结果骨巨细胞瘤从最初发病到恶变的间隔时间为18～108个月,平均59.5个月。随访时间平均为24.8个月,3例无疾病复发征象,2例带瘤存活,1例死亡。结论骨巨细胞瘤患者在初诊后3年以上复发,需要怀疑恶变的可能。早期发现、诊断,并行根治性手术,有望提高恶性骨巨细胞瘤的生存率,减少术后复发和转移率。若手术困难,可考虑行高强度聚焦超声治疗。
Objective To explore the treatments for malignant giant cell tumor of bone,seek for the references and evidences for the survival improvements and reduction rates of local recurrence and metastasis. Methods 6 cases from January 2001 to December 2012 were chosen,who had been clearly diagnosed as malignant giant cell tumor of bone and were followed up successfully. The 6 cases consisted of 3 males and 3 females respectively,their mean age was 28. 8 years old,of which,four cases had the histories of conventional benign giant cell tumor of bone,three cases received radical surgeries,one case received intralesional curettage and adjuvant therapy to inactivate the residual tumor cells together with bone grafting and internal fixation,one case was treated with high intensity focused ultrasound therapy,and another with chemotherapy followed by symptomatic and supportive therapy. Results The internal time from initial diagnosis of giant cell tumor of bone to malignant transformation was 18 to 108 months,averaged 59. 9 months. Mean follow-up time was 24. 8 months,three cases had no evidences of diseases,two were alive with tumors and one died. Conclusions Giant cell tumor of bone appears local recurrence over 3 years after the initial diagnosis should be considered the possibility to become malignant. In order to improve the prognosis and reduce the recurrent and metastatic rates, it is advocated that early detection and diagnosis should be made,and radical surgery should be performed on patients with malignant giant cell tumor of bone. High intensity focused ultrasound therapy should be considered where the lesions are unresectable.
出处
《中国肿瘤外科杂志》
CAS
2013年第4期205-208,共4页
Chinese Journal of Surgical Oncology
基金
国家自然科学基金(No.81171683/H0604)
关键词
恶性骨巨细胞瘤
治疗
诊断
随访
malignancy giant cell tumor of bone
treatment
diagnosis
follow-up
