Chen Kun-Hui, Wu Po-Kuei, Chen Cheng-Fong, Chen Wei-Ming
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No 201, Sec 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC.
School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Eur Spine J. 2015 Oct;24(10):2182-8. doi: 10.1007/s00586-015-3978-y. Epub 2015 May 5.
Giant cell tumor of the sacrum is usually silent in initial stages and not diagnosed until achieving a large size. Intralesional curettage of the tumor has lower risk of neurological damage but is with high recurrence rate. Zoledronic acid-loaded cement was demonstrated to have cytotoxic effect on the cell line of giant cell tumor. This study evaluate if zoledronic acid-loaded bone cement would reduce the recurrence rate of sacral giant cell tumor after intralesional curettage.
Four patients were diagnosed as sacral giant cell tumor and received intralesional curettage with placement of zoledronic acid-loaded bone cement for adjuvant local control. The clinical records including tumor location, tumor size, complication, follow-up status, and functional outcome were analyzed retrospectively.
All four patients presented with cauda equina syndrome before surgery with mean tumor volume of 472.8 cm(3). With placement of zoledronic acid-loaded cement, no local recurrence was observed during the mean follow-up period of 28 months. All patients were found to have new bone regeneration on radiograph. All patients suffering from cauda equina syndrome were recovered.
We suggested that placement of zoledronic acid-loaded bone cement was an effective adjuvant therapy for sacral giant cell tumor following intralesional curettage.
骶骨巨细胞瘤在初始阶段通常没有症状，直到肿瘤长得很大才会被诊断出来。肿瘤刮除术导致神经损伤的风险较低，但复发率高。载唑来膦酸骨水泥对巨细胞瘤细胞系具有细胞毒性作用。本研究评估载唑来膦酸骨水泥是否会降低骶骨巨细胞瘤刮除术后的复发率。
4例患者被诊断为骶骨巨细胞瘤，并接受了刮除术及植入载唑来膦酸骨水泥进行辅助局部控制。回顾性分析患者的临床记录，包括肿瘤位置、肿瘤大小、并发症、随访情况和功能结果。
所有4例患者术前均出现马尾综合征，平均肿瘤体积为472.8 cm³。植入载唑来膦酸骨水泥后，在平均28个月的随访期内未观察到局部复发。所有患者在X线片上均有新骨形成。所有患有马尾综合征的患者均康复。
我们认为，植入载唑来膦酸骨水泥是骶骨巨细胞瘤刮除术后一种有效的辅助治疗方法。
