Sun Sheng, Zhang Qiang, Zhao Chang-Song, Cai Juan
Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, P.R. China.
Oncol Lett. 2014 Jul;8(1):145-150. doi: 10.3892/ol.2014.2092. Epub 2014 Apr 25.
Giant cell tumors (GCTs) are generally benign, locally aggressive lesions with the potential to metastasize and a tendency of local recurrence. The present study aimed to investigate the advantages and long-term outcomes of application of ultrasonic scalpel in the treatment of GCT of long bones. This study retrospectively analyzed 32 cases of GCT of long bones, including 24 males and eight females. The age range was from 8 to 34 years old (mean age, 23.5 years old). The 32 cases were randomly divided into an observation group (n=10) and a control group (n=22). Patients in the observation group received curettage by ultrasonic scalpel combined with local methotrexate gelfoam adjuvant treatment, and then the cavity was filled with allograft and/or homograft bone. Patients in the control group eceived curettage by local methotrexate gelfoam adjuvant treatment and bone grafting. No local recurrence or pulmonary metastases were observed among patients in the observation group, however, six patients in the control group exhibited recurrence following surgery, although none of the patients demonstrated distant metastasis (P<0.05). Additionally, all 10 patients showed good bone knitting and rehabilitation without deformity and functional issues. The segmental bone graft was perfectly incorporated without obvious immune rejection, collapse and fracture. Curettage by ultrasonic scalpel with local methotrexate gelfoam adjuvant treatment and filling the site by allograft and/or homograft bone showed satisfactory results.
骨巨细胞瘤(GCTs)通常是良性的,但具有局部侵袭性,有转移的可能和局部复发的倾向。本研究旨在探讨超声刀在长骨骨巨细胞瘤治疗中的优势及长期疗效。本研究回顾性分析了32例长骨骨巨细胞瘤患者,其中男性24例,女性8例。年龄范围为8至34岁(平均年龄23.5岁)。将32例患者随机分为观察组(n = 10)和对照组(n = 22)。观察组患者采用超声刀刮除联合局部甲氨蝶呤明胶海绵辅助治疗,然后用同种异体骨和/或同种移植骨填充骨腔。对照组患者采用局部甲氨蝶呤明胶海绵辅助刮除及植骨治疗。观察组患者未观察到局部复发或肺转移,然而,对照组有6例患者术后出现复发,尽管所有患者均未出现远处转移(P < 0.05)。此外,所有10例患者均显示出良好的骨愈合和康复情况,无畸形和功能问题。节段性骨移植完全融合,无明显免疫排斥、塌陷和骨折。超声刀刮除联合局部甲氨蝶呤明胶海绵辅助治疗并采用同种异体骨和/或同种移植骨填充骨腔显示出满意的效果。