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不可切除的骶骨巨细胞瘤：治疗选择与疼痛控制

Inoperable Sacral Giant Cell Tumor: Therapeutic Options and Pain Control.

作者信息

Viana Eneida de Mattos Brito Oliveira, Batista Katia Torres, Carneiro Junior José Leite

机构信息

Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2019 May;54(3):347-352. doi: 10.1055/s-0039-1692450. Epub 2019 Jun 27.

DOI:10.1055/s-0039-1692450
PMID:31363293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6597425/
Abstract

Sacral giant cell tumor (GCT) is a rare condition. Its treatment is complex, since surgical removal is difficult and the response to other therapeutic options is low. The control of its growth and pain is an additional challenge. The present paper reports a case of inoperable sacral GCT, with embolization and radiotherapy for pain control as therapeutic options. The patient, a 39-year-old male, presented pain in the sacral region with lower limb irradiation due to an inoperable sacral giant cell tumor. The patient was submitted to embolization, radiotherapy, pain management with opioids and other drugs, and a rehabilitation program. Despite the difficulty in tumor growth and pain control during the follow-up, the outcome is stable after 9 years.

摘要

骶骨巨细胞瘤（GCT）是一种罕见疾病。其治疗较为复杂，因为手术切除困难，且对其他治疗方案的反应不佳。控制其生长和疼痛是另一项挑战。本文报告了一例无法手术切除的骶骨GCT病例，采用栓塞和放射治疗来控制疼痛作为治疗选择。该患者为一名39岁男性，因无法手术切除的骶骨巨细胞瘤出现骶骨区域疼痛并伴有下肢放射性疼痛。患者接受了栓塞、放疗、使用阿片类药物和其他药物进行疼痛管理以及康复计划。尽管在随访期间控制肿瘤生长和疼痛存在困难，但9年后病情稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/b381d0a742ed/10-1055-s-0039-1692450-i180007pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/5c457d045bf6/10-1055-s-0039-1692450-i180007en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/c00bca1c331c/10-1055-s-0039-1692450-i180007en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/57a789b7b129/10-1055-s-0039-1692450-i180007en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/31c56ca3f511/10-1055-s-0039-1692450-i180007en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/38e51ceb90bb/10-1055-s-0039-1692450-i180007pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/736a38223a46/10-1055-s-0039-1692450-i180007pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/7d29fd24426f/10-1055-s-0039-1692450-i180007pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/b381d0a742ed/10-1055-s-0039-1692450-i180007pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/5c457d045bf6/10-1055-s-0039-1692450-i180007en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/c00bca1c331c/10-1055-s-0039-1692450-i180007en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/57a789b7b129/10-1055-s-0039-1692450-i180007en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/31c56ca3f511/10-1055-s-0039-1692450-i180007en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/38e51ceb90bb/10-1055-s-0039-1692450-i180007pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/736a38223a46/10-1055-s-0039-1692450-i180007pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/7d29fd24426f/10-1055-s-0039-1692450-i180007pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/6597425/b381d0a742ed/10-1055-s-0039-1692450-i180007pt-4.jpg

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Denosumab induces tumor reduction and bone formation in patients with giant-cell tumor of bone.地舒单抗可诱导骨巨细胞瘤患者肿瘤缩小和骨形成。
Clin Cancer Res. 2012 Aug 15;18(16):4415-24. doi: 10.1158/1078-0432.CCR-12-0578. Epub 2012 Jun 18.
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Systemic effects of local radiotherapy.局部放疗的全身效应
Indian J Surg Oncol. 2024 Mar;15(Suppl 1):86-93. doi: 10.1007/s13193-020-01153-z. Epub 2020 Aug 1.
Lancet Oncol. 2009 Jul;10(7):718-26. doi: 10.1016/S1470-2045(09)70082-8.
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Giant cell tumor of the cervical spine: a series of 22 cases and outcomes.颈椎骨巨细胞瘤：22例病例系列及结果
Spine (Phila Pa 1976). 2008 Feb 1;33(3):280-8. doi: 10.1097/BRS.0b013e318162454f.