骨巨细胞瘤的治疗方案与并发症的相关性分析(1)
摘 要：目的 分析骨巨细胞瘤的治疗方案与并发症的相关性。方法 回顾性分析2005年1月～2013年12月于山东大学齐鲁医院进行骨巨细胞瘤手术治疗患者56例，记录患者年龄、性别、肿瘤发生部位、术后辅助治疗方案、术式及并发症发生率。结果 术后进行辅助治疗患者并发症发生率为43.48%，高于未进行辅助治疗患者的15.15%，差异有统计学意义(P<0.05);采用肿瘤切除+物理化学方法治疗患者并发症发生率为41.94%，高于单纯切除患者的0，差异有统计学意义(P<0.05);扩大切除组患者的并发症发生率为12.50%，低于单纯切除患者，高于切除+物理化学方法，差异均有统计学意义(P<0.05)。结论 骨巨细胞瘤患者术后放疗或应用双膦酸盐类药物辅助治疗，采用肿瘤切除+物理化学方法及肿瘤扩大切除会增加患者术后并发症的发生率，因此应根据患者具体情况选择术式。
关键词：骨巨细胞瘤;并发症;相关因素
中图分类号：R738.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.051
, 百拇医药
文章编号：1006-1959(2018)24-0167-03
Abstract：Objective To analyze the the correlation between treatment regimen and complications of complications of giant cell tumor of bone. Methods A retrospective analysis of 56 patients with giant cell tumor of the bone at Qilu Hospital of Shandong University from January 2005 to December 2013 was performed. The age， sex， tumor location， postoperative adjuvant treatment， surgery and complications were recorded. Incidence. Results The incidence of postoperative complication was 43.48%， which was higher than that of 15.15% of patients without adjuvant therapy. The difference was statistically significant (P<0.05).The incidence of complication was 41.94% in patients treated with tumor resection+physical chemistry， which was significantly higher than that in patients with simple resection (P<0.05). The complication rate in patients with enlarged resection was 12.50%， low. In patients with simple resection， the difference was statistically significant (P<0.05). Conclusion In patients with giant cell tumor of the bone， postoperative radiotherapy or bisphosphonate adjuvant therapy， tumor resection + physicochemical methods and enlarged tumor resection will increase the incidence of postoperative complications， so the choice should be based on the patient's specific conditions.
, 百拇医药
Key words：Giant cell tumor of bone;Complications;Related factors
骨巨细胞瘤(giant cell tumor of bone，GCTB)是发病率较高的一种具有恶性倾向的骨肿瘤，1818 年由 Copper首次描述，占所有原发性骨肿瘤的3%～5%，良性骨肿瘤的15%[1]。骨巨细胞瘤发病年龄在20～50岁，四肢长骨干骺端最为常见，尤其是临近膝关节的股骨远端和胫骨近端，亦可发生于脊柱、骨盆等部位[2，3]。常规刮除术后有较高的局部复发率，肺转移率1%～9%[4，5]。骨巨细胞瘤生物学行为复杂多变，呈侵袭性生长，并且具有局部复发倾向，部分患者发生肺转移或肉瘤变，预后极差[6，7]。一直以来，骨巨细胞瘤的研究从细胞发生、组织學性质和分级方法等随着科技社会的进步而不断发生变化[8，9]。手术治疗为诊断时无远处转移的骨巨细胞瘤患者的首选治疗方案，只要患者能够耐受手术，均应向其建议手术干预肿瘤的自然病程[10]。对于可切除的骨巨细胞瘤，主要的手术方式包括广泛切除和病灶内刮除两种。虽然可以辅助放疗、IFN、Denosumab等治疗，但广泛切除的复发率为0～12%，而刮除术的复发率为12%～65%，广泛切除的复发风险较低，但大面积的手术切除会导致严重的并发症或功能缺失，因此最理想的治疗方案仍然没有达成共识。本研究拟对2005年1月～2013年12月在山东大学齐鲁医院行手术治疗的56例骨巨细胞瘤患者进行随访分析，为今后骨巨细胞瘤的治疗提供参考。, http://www.100md.com(孟思博 赵成)
关键词：骨巨细胞瘤;并发症;相关因素
中图分类号：R738.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.051
, 百拇医药
文章编号：1006-1959(2018)24-0167-03
Abstract：Objective To analyze the the correlation between treatment regimen and complications of complications of giant cell tumor of bone. Methods A retrospective analysis of 56 patients with giant cell tumor of the bone at Qilu Hospital of Shandong University from January 2005 to December 2013 was performed. The age， sex， tumor location， postoperative adjuvant treatment， surgery and complications were recorded. Incidence. Results The incidence of postoperative complication was 43.48%， which was higher than that of 15.15% of patients without adjuvant therapy. The difference was statistically significant (P<0.05).The incidence of complication was 41.94% in patients treated with tumor resection+physical chemistry， which was significantly higher than that in patients with simple resection (P<0.05). The complication rate in patients with enlarged resection was 12.50%， low. In patients with simple resection， the difference was statistically significant (P<0.05). Conclusion In patients with giant cell tumor of the bone， postoperative radiotherapy or bisphosphonate adjuvant therapy， tumor resection + physicochemical methods and enlarged tumor resection will increase the incidence of postoperative complications， so the choice should be based on the patient's specific conditions.
, 百拇医药
Key words：Giant cell tumor of bone;Complications;Related factors
骨巨细胞瘤(giant cell tumor of bone，GCTB)是发病率较高的一种具有恶性倾向的骨肿瘤，1818 年由 Copper首次描述，占所有原发性骨肿瘤的3%～5%，良性骨肿瘤的15%[1]。骨巨细胞瘤发病年龄在20～50岁，四肢长骨干骺端最为常见，尤其是临近膝关节的股骨远端和胫骨近端，亦可发生于脊柱、骨盆等部位[2，3]。常规刮除术后有较高的局部复发率，肺转移率1%～9%[4，5]。骨巨细胞瘤生物学行为复杂多变，呈侵袭性生长，并且具有局部复发倾向，部分患者发生肺转移或肉瘤变，预后极差[6，7]。一直以来，骨巨细胞瘤的研究从细胞发生、组织學性质和分级方法等随着科技社会的进步而不断发生变化[8，9]。手术治疗为诊断时无远处转移的骨巨细胞瘤患者的首选治疗方案，只要患者能够耐受手术，均应向其建议手术干预肿瘤的自然病程[10]。对于可切除的骨巨细胞瘤，主要的手术方式包括广泛切除和病灶内刮除两种。虽然可以辅助放疗、IFN、Denosumab等治疗，但广泛切除的复发率为0～12%，而刮除术的复发率为12%～65%，广泛切除的复发风险较低，但大面积的手术切除会导致严重的并发症或功能缺失，因此最理想的治疗方案仍然没有达成共识。本研究拟对2005年1月～2013年12月在山东大学齐鲁医院行手术治疗的56例骨巨细胞瘤患者进行随访分析，为今后骨巨细胞瘤的治疗提供参考。, http://www.100md.com(孟思博 赵成)