Rao Sandesh S, El Abiad Jad M, Puvanesarajah Varun, Levin Adam S, Jones Lynne C, Morris Carol D
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Surg Oncol. 2019 Mar;28:214-221. doi: 10.1016/j.suronc.2019.02.001. Epub 2019 Feb 4.
Several treatment regimens for childhood malignancies have been associated with the development of osteonecrosis, including radiation therapy, glucocorticoid medications, immunotherapy (including anti-angiogenic agents), and several chemotherapeutic agents. Adolescents older than 10 years are at greatest risk of developing osteonecrosis within 1 year of initiating therapy. Screening with magnetic resonance imaging in this high-risk population may be a useful method for detecting osteonecrosis. Surgery may be required for lesions that have progressed substantially despite nonoperative interventions.
几种儿童恶性肿瘤的治疗方案与骨坏死的发生有关，包括放射治疗、糖皮质激素药物、免疫疗法（包括抗血管生成药物）以及几种化疗药物。10岁以上的青少年在开始治疗后1年内发生骨坏死的风险最高。对这一高危人群进行磁共振成像筛查可能是检测骨坏死的一种有用方法。对于尽管采取了非手术干预但仍有显著进展的病变，可能需要进行手术。
