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辅助钇羟磷灰石对膝关节弥漫型腱鞘巨细胞瘤放射性滑膜切除术疗效不明确。

Inconclusive benefit of adjuvant Yttrium hydroxyapatite to radiosynovectomy for diffuse-type tenosynovial giant-cell tumour of the knee.

机构信息

National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Bone Joint J. 2018 Jul;100-B(7):984-988. doi: 10.1302/0301-620X.100B7.BJJ-2017-0867.R3.

DOI:10.1302/0301-620X.100B7.BJJ-2017-0867.R3
PMID:29954214
Abstract

AIMS

Intra-articular Yttrium (Y) is an adjunct to surgical treatment by synovectomy for patients with diffuse-type tenosynovial giant-cell tumour (dtTGCT) of the knee, with variable success rates. Clinical information is, however, sparse and its value remains unclear. We investigated the long-term outcome of patients who underwent synovectomy with and without adjuvant treatment with Yttrium.

PATIENTS AND METHODS

All patients with dtTGCT of the knee who underwent synovectomy between 1991 and 2014 were included in the study. Group A patients underwent synovectomy and an intra-articular injection of Yttrium between six and eight weeks after surgery. Group B patients underwent surgery alone.

RESULTS

There were 34 patients in group A and 22 in group B. Recurrence of dtTGCT was identified by MRI, which was undertaken in patients with further symptoms. At a mean follow-up of 7.3 years (2.5 to 25.4), there was residual disease in 15 patients in group A and 11 in group B (p < 0.363). The mean Musculoskeletal Tumor Society (MSTS) score at final follow-up was 85% and 83%, respectively (p < 0.91).

CONCLUSION

There were no significant differences in outcome between patients treated surgically for dtTGCT of the knee with or without an adjuvant intra-articular injection of Yttrium. We were unable to provide conclusive evidence of any benefits derived from the adjuvant treatment. Cite this article: Bone Joint J 2018;100-B:984-8.

摘要

目的

关节内钇(Y)是膝关节弥漫型腱鞘巨细胞瘤(dtTGCT)滑膜切除术的辅助治疗方法,其成功率不一。然而,临床资料很少,其价值仍不清楚。我们研究了接受滑膜切除联合和不联合 Yttrium 辅助治疗的患者的长期结果。

患者和方法

研究纳入了 1991 年至 2014 年间接受膝关节 dtTGCT 滑膜切除术的所有患者。A 组患者在手术后 6 至 8 周内行滑膜切除和关节内注射 Yttrium。B 组患者仅行手术治疗。

结果

A 组有 34 例患者,B 组有 22 例患者。通过 MRI 检查识别 dtTGCT 的复发,对有进一步症状的患者进行 MRI 检查。平均随访 7.3 年(2.5 至 25.4 年),A 组有 15 例患者和 B 组有 11 例患者存在残留疾病(p<0.363)。最终随访时,平均 MSTS 评分分别为 85%和 83%(p<0.91)。

结论

膝关节 dtTGCT 患者接受手术治疗时,联合或不联合关节内注射 Yttrium 的治疗效果无显著差异。我们无法提供辅助治疗获益的明确证据。

文献来源

Bone Joint J 2018;100-B:984-8.

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