Charest-Morin Raphaële, Boriani Stefano, Fisher Charles G, Patel Shreyaskumar R, Kawahara Norio, Mendel Ehud, Bettegowda Chetan, Rhines Laurence D
Department of Orthopaedic, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada.
Department of Degenerative and Oncological Spine Surgery, Rizzoli Institute Bologna, Bologna, Italy.
Spine (Phila Pa 1976). 2016 Oct 15;41 Suppl 20:S178-S185. doi: 10.1097/BRS.0000000000001818.
Clinically based systematic review.
To determine the role of (A) medical treatment and (B) interventional radiology as either adjuvant or stand-alone treatment in primary benign bone tumors of the spine.
A multidisciplinary panel of spine surgeons, radiation oncologists, and medical oncologists elaborated specific focused questions regarding aneurysmal bone cyst, giant cell tumor, and osteoid osteoma. Denosumab, bisphosphonate, interferon, bone marrow aspirate, doxycycline, thermal ablation, and selective arterial embolization were identified as areas of interest for the article. A systematic review was performed through MEDLINE and EMBASE. Recommendations based on the literature review and clinical expertise were issued using the GRADE system.
The overall quality of the literature is very low with few multicenter prospective studies. For giant cell tumor, combination with Denosumab identified 14 pertinent articles with four multicenter prospective studies. Nine studies were found on bisphosphonates and six for selective arterial embolization. The search on aneurysmal bone cyst and selective arterial embolization revealed 12 articles. Combination with Denosumab, Doxycycline, and bone marrow aspirate identified four, two, and three relevant articles respectively. Eleven focused articles were selected on the role of thermal ablation in osteoid osteoma.
Alternative and adjuvant therapy for primary benign bone tumors have emerged. Their ability to complement or replace surgery is now being scrutinized and they may impact significantly the algorithm of treatment of these tumors. Most of the data are still emerging and further research is desirable. Close collaboration between the different specialists managing these pathologies is crucial.
N/A.
基于临床的系统评价。
确定（A）药物治疗和（B）介入放射学作为脊柱原发性良性骨肿瘤的辅助治疗或独立治疗的作用。
由脊柱外科医生、放射肿瘤学家和医学肿瘤学家组成的多学科小组拟定了关于骨动脉瘤、骨巨细胞瘤和骨样骨瘤的特定重点问题。地诺单抗、双膦酸盐、干扰素、骨髓抽吸物、强力霉素、热消融和选择性动脉栓塞被确定为本文感兴趣的领域。通过MEDLINE和EMBASE进行系统评价。使用GRADE系统根据文献综述和临床专业知识发布建议。
文献的总体质量很低，多中心前瞻性研究很少。对于骨巨细胞瘤，与地诺单抗联合使用共检索到14篇相关文章，其中有4篇多中心前瞻性研究。发现9篇关于双膦酸盐的研究，6篇关于选择性动脉栓塞的研究。关于骨动脉瘤和选择性动脉栓塞的检索共发现12篇文章。与地诺单抗、强力霉素和骨髓抽吸物联合使用分别检索到4篇、2篇和3篇相关文章。选择了11篇关于热消融在骨样骨瘤中作用的重点文章。
原发性良性骨肿瘤的替代治疗和辅助治疗已经出现。它们补充或替代手术的能力目前正在接受审查，并且可能对这些肿瘤的治疗方案产生重大影响。大多数数据仍在不断涌现，需要进一步研究。管理这些疾病的不同专科医生之间密切合作至关重要。
不适用。
