Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
World J Surg Oncol. 2018 Dec 28;16(1):241. doi: 10.1186/s12957-018-1545-9.
Radiation therapy is an important therapeutic element in musculoskeletal tumours, especially when encountering multiple or painful lesions. In osteolytic lesions, a surgical stabilization with implants is often required. However, metallic implants not only complicate the CT-based planning of a subsequent radiation therapy, but also have an uncontrollable dose-modulating effect in adjuvant radiotherapy. In addition, follow-up imaging and the diagnosis of local recurrences are often obscured by metallic artefacts. Radiolucent implants consisting of carbon/polyether ether ketone (CF/PEEK) therefore facilitate adjuvant radiation therapy and follow-up imaging of bone lesions. We hereby present clinical cases with application of CF/PEEK implants in orthopaedic tumour surgery.
We report a single-centre experience of three selected patients with surgical stabilization of osteolytic bone lesions using CF/PEEK implants. Detailed information about the clinical presentation, preoperative considerations, surgical procedures and postoperative results is provided for each case.
One spinal lesion (T12 vertebral body), one lesion of the upper extremity (humerus) and one of the lower extremities (tibia) were surgically stabilized with use of CF/PEEK implants. With a mean follow-up of 12 months (range 6-25 months), no adverse events were observed. Two patients received adjuvant radiotherapy. Follow-up imaging was obtained in all patients.
The applicability of CF/PEEK implants in orthopaedic tumour surgery is good with respect to postoperative follow-up imaging, application of adjuvant radiotherapy and intraoperative handling. As a result of the unique material properties, oncological patients might particularly benefit from CF/PEEK implants.
放射治疗是肌肉骨骼肿瘤的重要治疗手段,尤其是在遇到多发性或疼痛性病变时。在溶骨性病变中,通常需要用植入物进行手术稳定。然而,金属植入物不仅使基于 CT 的后续放射治疗计划变得复杂,而且在辅助放疗中具有不可控的剂量调节作用。此外,随访成像和局部复发的诊断经常被金属伪影所掩盖。由碳纤维/聚醚醚酮(CF/PEEK)制成的透光植入物因此有利于辅助放射治疗和骨病变的随访成像。我们在此介绍在骨科肿瘤手术中应用 CF/PEEK 植入物的临床病例。
我们报告了使用 CF/PEEK 植入物对 3 例溶骨性骨病变进行手术稳定的单中心经验。详细介绍了每位患者的临床表现、术前考虑、手术步骤和术后结果。
使用 CF/PEEK 植入物对 1 例脊柱病变(T12 椎体)、1 例上肢病变(肱骨)和 1 例下肢病变(胫骨)进行了手术稳定。平均随访 12 个月(6-25 个月),无不良事件发生。2 例患者接受了辅助放疗。所有患者均获得了随访成像。
CF/PEEK 植入物在骨科肿瘤手术中的应用在术后随访成像、辅助放疗的应用和手术处理方面效果良好。由于独特的材料特性,癌症患者可能特别受益于 CF/PEEK 植入物。