Department of Dentistry, Maringá State University, Avenida Mandacaru, Maringá, Paraná, 87080-000, Brazil.
Clin Oral Investig. 2022 Feb;26(2):2111-2132. doi: 10.1007/s00784-021-04193-z. Epub 2021 Oct 1.
To evaluate the effectiveness of non-surgical treatment as an alternative in the management of central giant cell granuloma (CGCG).
A literature search was carried out in accordance with the PRISMA statement in order to answer the question "Are non-surgical treatments effective as an alternative in the treatment of CGCG?". Two examiners independently assessed eligibility, risk of bias, and extracted data, which included therapeutic protocol, side effects, and need for surgical supplementation.
Among 1712 studies, 15 were included, totaling 145 patients. Calcitonin, intralesional corticosteroids, and denosumab were the medications used. For calcitonin (n = 61), complete remission was found in 30 cases. For intralesional triamcinolone (n = 68), reduction in size was observed in most cases (n = 39). Four cases received subcutaneous denosumab and showed absence of active bone metabolism in the region, of which three presented ossification. Combination of drug therapies (n = 29) was reported in one study and included subcutaneous interferon and oral imatinib. More and less side effects were found for interferon and corticosteroids, respectively. Forty percent of patients required additional surgical treatment.
Despite the side effects presented and the need for additional surgery in some patients, in general, all non-surgical treatments could provide positive results as an alternative for the management of CGCG, especially with regard to reducing the size of the lesion.
CGCG is a benign bone lesion that mainly affects young individuals. Although the most common therapy is surgery, its contraindication in some patients, the large extension, and high recurrence rate of the aggressive variant have led the search for non-surgical therapies.
评估非手术治疗作为中央性颌骨 giant cell 肉芽肿（CGCG）治疗方法的一种替代方案的有效性。
根据 PRISMA 声明进行文献检索，以回答“非手术治疗作为 CGCG 的一种替代方案是否有效？”这一问题。两位检查者独立评估了纳入研究的资格、偏倚风险，并提取了治疗方案、副作用和手术补充需求等数据。
在 1712 项研究中，有 15 项研究被纳入，共纳入 145 例患者。降钙素、皮质内固醇和地舒单抗是使用的药物。对于降钙素（n=61），30 例患者完全缓解。对于皮质内固醇（n=68），大多数病例体积减小（n=39）。4 例患者接受皮下注射地舒单抗，区域内无活跃的骨代谢，其中 3 例出现骨化。一项研究报告了药物联合治疗（n=29），包括皮下干扰素和口服伊马替尼。干扰素和皮质内固醇的副作用分别更多和更少。40%的患者需要额外的手术治疗。
尽管存在副作用，且部分患者需要额外的手术，但总的来说，所有非手术治疗都可以作为 CGCG 治疗的替代方案，提供积极的结果，尤其是在缩小病变方面。
CGCG 是一种主要影响年轻人的良性骨病变。尽管最常见的治疗方法是手术，但对于某些患者存在禁忌，侵袭性变体的病变范围大且复发率高，这促使人们寻求非手术治疗。
