Department of Orthopedics, Peking University Third Hospital, Beijing, China.
Spine (Phila Pa 1976). 2010 Nov 15;35(24):E1418-22. doi: 10.1097/BRS.0b013e3181e7bf5a.
Case report.
To demonstrate that interferon alfa-2b is a therapeutic option for obtaining long-term control of recurrent and metastatic giant cell tumor of spine.
Interferon alfa served as angiogenesis inhibitor and has been successfully used to treat giant cell tumor of long bones and facial bones. Up to date, no report is found with regard to the use of interferon as a stand-alone treatment for unresectable, recurrent, and metastatic giant cell tumor originated from the spine.
A 29-year-old woman with C1 and C2 giant cell tumor was treated by radiotherapy, intralesional curet, and chemotherapy orderly. Tumor recurred after 2 years. A second curet was undertaken. Tumor recurred second time and caused severe spinal cord compression. Lung metastasis was diagnosed simultaneously. A 24-year-old man with recurrent giant cell tumor of T5 and T6 was treated by spondylectomy of T5 and T6. Six months later, a giant metastatic lesion was found in sacrococcygeal region, which was excised and proved to be giant cell tumor of bone. Four months later, 2 recurrent lesions were found beside the rectum. Interferon alfa-2b at a dose of 3,000,000 U/m was then administered subcutaneously everyday for both patients for 3.5 and 3 years, respectively.
No major complications related to the use of interferon occurred. The lesion in C1-C2 of the first patient regressed steadily and was restricted and encircled within the lateral mass. The metastatic lesions in the lungs also significantly reduced. The pararectal lesions of the second patient disappeared completely.
Interferon therapy may be an effective and safe treatment for spine giant cell tumor recurrence and metastasis in soft tissue. The effectiveness may be time and dosage dependent.
病例报告。
证明干扰素 alfa-2b 是控制复发性和转移性脊柱巨细胞瘤的一种治疗选择。
干扰素 alfa 作为血管生成抑制剂已成功用于治疗长骨和面部骨的巨细胞瘤。迄今为止，尚未有关于干扰素作为不可切除、复发性和转移性起源于脊柱的巨细胞瘤的单一治疗方法的报告。
一名 29 岁女性 C1 和 C2 巨细胞瘤患者先后接受了放疗、病灶内切除术和化疗。2 年后肿瘤复发，再次进行病灶切除术。第二次肿瘤复发并导致严重脊髓压迫，同时诊断出肺转移。一名 24 岁男性 T5 和 T6 复发性巨细胞瘤患者接受了 T5 和 T6 的椎体切除术。6 个月后，在尾骨区发现一个巨大的转移性病变，切除后证实为骨巨细胞瘤。4 个月后，直肠旁发现 2 个复发病变。随后，两名患者分别每天皮下注射 300 万 U 的干扰素 alfa-2b，分别治疗 3.5 年和 3 年。
未发生与干扰素使用相关的重大并发症。第一个患者的 C1-C2 病变稳定消退，被限制在侧块内并环绕。肺部的转移性病变也明显减少。第二个患者的直肠旁病变完全消失。
干扰素治疗可能是一种有效且安全的治疗脊柱巨细胞瘤复发和软组织转移的方法。疗效可能与时间和剂量有关。
