Schreuder Willem Hans, van den Berg Henk, Westermann Anne Marie, Peacock Zachary Scott, de Lange Jan
Department of Oral and Maxillofacial Surgery (Head: Prof. J. de Lange), Academic Medical Center, Academic Center Dentistry Amsterdam and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Department of Pediatric Oncology, Academic Medical Center, Emma Children Hospital and University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
J Craniomaxillofac Surg. 2017 Feb;45(2):232-243. doi: 10.1016/j.jcms.2016.11.011. Epub 2016 Dec 9.
This is a retrospective cohort study of patients with a central giant cell granuloma (CGCG) treated at a single center to assess and compare the different surgical and non-surgical approaches.
A cohort with a single histologically proven non-syndrome-related CGCG was selected and reviewed. Patients were allocated to group I (surgery), group II (pharmacotherapy), and group III (pharmacotherapy and surgery). The primary outcome was long-term radiologic response using computed tomography. Secondary outcomes were intermediate radiologic responses and occurrence and severity of side effects.
Thirty-three subjects were included in the study. The surgical group (n = 4) included 1 patient with progression during follow-up and a relatively high post-surgical morbidity. Twenty-nine patients started on various pharmacological treatment regimens (groups II and III). Fourteen patients could be managed without additional surgery. One of these lesions showed progression during follow-up. The other 15 lesions underwent additional surgery, and none showed progression during follow-up. Interferon treatment was associated with the most side effects.
Pharmacological agents have a role in the treatment of aggressive and non-aggressive CGCGs by limiting the renewed progression during long-term follow up and the extent and morbidity of surgical treatment.
这是一项对在单一中心接受治疗的中心巨细胞肉芽肿（CGCG）患者的回顾性队列研究，旨在评估和比较不同的手术及非手术方法。
选取一组经组织学证实的非综合征相关性CGCG患者并进行回顾性研究。患者被分为I组（手术治疗）、II组（药物治疗）和III组（药物治疗联合手术治疗）。主要结局指标是使用计算机断层扫描评估的长期影像学反应。次要结局指标是中期影像学反应以及副作用的发生情况和严重程度。
本研究共纳入33名受试者。手术组（n = 4）中有1例患者在随访期间病情进展，且术后发病率相对较高。29例患者开始接受各种药物治疗方案（II组和III组）。14例患者无需额外手术即可得到治疗。其中1例病变在随访期间出现进展。其他15例病变接受了额外手术，且在随访期间均未出现进展。干扰素治疗的副作用最多。
药物治疗在侵袭性和非侵袭性CGCG的治疗中发挥作用，可在长期随访中限制病情再次进展，并减少手术治疗的范围和发病率。
