Shen C C, Li H, Shi Z L, Tao H M, Yang Z M
Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Int Med Res. 2012;40(2):415-25. doi: 10.1177/147323001204000203.
Sacral giant cell tumour of bone has an insidious onset and slow growth rate, making early diagnosis difficult. The tumour has a high recurrence rate and is often fatal. Magnetic resonance imaging and computed tomography (CT), including CT-guided fine-needle biopsy, are useful for early diagnosis. Although therapy for sacral giant cell tumour often involves surgical resection and reconstruction challenges, improvements in various treatment modalities, including arterial embolization and radiotherapy, have widened the effective treatment options. The current surgical and adjuvant treatment modalities available for the management of sacral giant cell tumour are systematically reviewed and a suggested treatment algorithm is provided. En bloc excision remains the surgical procedure of choice, with functional reconstruction important in cases where the lesion is high in the sacrum. The use of adjuvant radiotherapy and chemotherapy remains controversial and should be studied further. Determination of the optimum treatment for sacral giant cell tumour will require randomized controlled trials. Early diagnosis, complete surgical resection with tumour-free margins and comprehensive treatment are important for local tumour control and improved outcome.
骶骨骨巨细胞瘤起病隐匿，生长缓慢，早期诊断困难。该肿瘤复发率高，常危及生命。磁共振成像和计算机断层扫描（CT），包括CT引导下细针穿刺活检，有助于早期诊断。尽管骶骨巨细胞瘤的治疗通常涉及手术切除及重建挑战，但包括动脉栓塞和放疗在内的各种治疗方式的改进拓宽了有效治疗选择。本文系统回顾了目前可用于骶骨巨细胞瘤治疗的手术及辅助治疗方式，并提供了建议的治疗方案。整块切除仍是首选的手术方式，对于骶骨高位病变，功能重建很重要。辅助放疗和化疗的使用仍存在争议，应进一步研究。确定骶骨巨细胞瘤的最佳治疗方案需要进行随机对照试验。早期诊断、实现切缘无肿瘤的完整手术切除以及综合治疗对于局部肿瘤控制和改善预后至关重要。
