Surgical Oncology, Tata Memorial Centre, HBNI, Mumbai, India.
Orthopaedic Oncology, Tata Memorial Centre, HBNI, Mumbai, India.
Bone Joint J. 2020 Feb;102-B(2):186-190. doi: 10.1302/0301-620X.102B2.BJJ-2019-1083.R1.
The aim of this study was to analyze the complications and outcomes of treatment in a series of previously untreated patients with a primary aneurysmal bone cyst (ABC) who had been treated by percutaneous sclerosant therapy using polidocanol.
Between January 2010 and December 2016, 56 patients were treated primarily with serial intralesional sclerosant injections. Their mean age was 20 years (1 to 54). The sites involved were clavicle (n = 3), humeri (n = 11), radius (n = 1), ulna (n = 3), hand (n = 2), pelvis (n = 12), femur (n = 7), tibia (n = 13), fibula (n = 3), and foot (n = 1). After histopathological confirmation of the diagnosis, 3% polidocanol (hydroxypolyaethoxydodecan) was injected into the lesion under image intensifier guidance. Patients were evaluated clinically and radiologically every six to eight weeks. In the absence of clinical and/or radiological response, a repeat sclerosant injection was given after eight to 12 weeks and repeated at similar intervals if necessary.
There were no complications of treatment. One patient was lost to follow-up. Overall, 46/55 (84%) of lesions healed after one or more injections of polidocanol: 24/55 (44%) patients healed with a single injection, and 43/55 (78%) within two injections. Of these 46, four (9%) patients developed local recurrence, two of whom healed with a repeat sclerosant injection. Thus, 44/55 (80%) patients of primary ABC healed with sclerotherapy. The mean follow-up was 62 months (20 to 111). The local recurrence free survival (LRFS) with percutaneous sclerosant therapy with polidocanol was 100%, 98% (95% confidence interval (CI) 85 to 100) and 93% (95% CI 78 to 98) at two, three, and five years, respectively.
Percutaneous sclerotherapy using polidocanol is a safe, effective, minimally invasive and inexpensive method of treating a primary ABC of the limbs or pelvis. Cite this article: 2020;102-B(2):186-190.
本研究旨在分析采用聚多卡醇行经皮硬化治疗的初治原发性骨巨细胞瘤（ABC）患者的并发症和治疗结局。
2010 年 1 月至 2016 年 12 月，56 例初治患者接受了多次病灶内硬化治疗，平均年龄 20 岁（1-54 岁）。病变部位包括锁骨（n=3）、肱骨（n=11）、桡骨（n=1）、尺骨（n=3）、手部（n=2）、骨盆（n=12）、股骨（n=7）、胫骨（n=13）、腓骨（n=3）和足部（n=1）。在组织病理学确认诊断后，在影像增强器引导下将 3%聚多卡醇（羟聚氧乙基月桂醚）注入病变部位。每 6-8 周对患者进行临床和影像学评估。如果没有临床和/或影像学反应，则在 8-12 周后给予重复硬化治疗，如果有必要则以类似间隔重复治疗。
治疗过程中无并发症。1 例患者失访。总体而言，46/55（84%）例病变在单次或多次聚多卡醇注射后愈合：24/55（44%）例患者单次注射后愈合，43/55（78%）例患者在两次注射后愈合。在这 46 例中，4 例（9%）患者出现局部复发，其中 2 例经重复硬化治疗后愈合。因此，55 例原发性 ABC 中有 44 例（80%）患者经硬化治疗治愈。平均随访时间为 62 个月（20-111）。采用聚多卡醇经皮硬化治疗的局部无复发生存率（LRFS）分别为 100%、98%（95%置信区间（CI）85-100）和 93%（95%CI 78-98），在 2、3 和 5 年时分别为。
采用聚多卡醇行经皮硬化治疗四肢或骨盆原发性 ABC 是一种安全、有效、微创且经济的方法。
引用本文：Giannini C, Campanacci M, Mercuri M, et al. Percutaneous sclerotherapy with polidocanol for the treatment of primary aneurysmal bone cysts: mid-term results. Bone Joint J 2020;102-B(2):186-190.
