a Academic Department of Trauma & Orthopaedics, School of Medicine , University of Leeds , Leeds , UK.
Expert Rev Med Devices. 2018 Apr;15(4):301-311. doi: 10.1080/17434440.2018.1456336. Epub 2018 Mar 26.
The fixation of impending or pathologic fractures is challenging and their successful management can have a favourable impact on the quality of life of the patient. The progression of the metastatic bone disease can cause significant pain and disability but also could result in the loosening and subsequent failure of the implants. To prevent the additional local growth, postoperative radiotherapy is often recommended, and many patients receive endocrine or chemotherapy.
Several reports support the antineoplastic drugs to bone cement as an adjuvant to improve implant stability as well as to prevent local cancer progression and failure of reconstructive devices used to treat patients with pathologic fractures. The aim of the present review is to present our current understanding on the effect of local delivery of antineoplastic drugs at the bone site.
Encouraging evidence support the application of bone cement loaded with antineoplastic drugs to fill defects and strengthen the fixation of orthopaedic implants. This is an inexpensive and safe method that can improve implant stability, prevent local cancer progression and failure of reconstructive devices. To fully evaluate its clinical effectiveness randomized clinical studies are needed.
对即将发生或病理性骨折的固定具有挑战性，成功的治疗可以对患者的生活质量产生有利影响。转移性骨病的进展会导致严重的疼痛和残疾，还可能导致植入物松动和随后的失败。为了防止局部进一步生长，常建议术后进行放射治疗，许多患者还接受内分泌或化学治疗。
多项报告支持将抗肿瘤药物与骨水泥联合应用作为辅助手段，以提高植入物的稳定性，预防局部癌症进展和用于治疗病理性骨折患者的重建器械的失败。本综述的目的是介绍我们目前对骨内局部递送抗肿瘤药物效果的理解。
有令人鼓舞的证据支持将载有抗肿瘤药物的骨水泥应用于填充缺损和增强骨科植入物的固定。这是一种廉价且安全的方法，可以提高植入物的稳定性，预防局部癌症进展和重建器械的失败。需要随机临床试验来全面评估其临床效果。
