Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea, 28670, Madrid, Spain.
Department of Radiation Oncology, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain; Cancer Molecular Biology Group, Section of Immuno-Oncology, Medical Research Center (CIMES), University of Malaga (UMA), Institute of Biomedical Research in Malaga (IBIMA), 29010, Málaga, Spain.
Int J Infect Dis. 2022 Feb;115:168-170. doi: 10.1016/j.ijid.2021.12.313. Epub 2021 Dec 7.
Hydatid disease usually affects the liver, but can also extend to other locations, such as the bones. In these cases, complete resection of the bone is considered the only curative approach. However, this is rarely feasible, and patients are left with benzimidazoles as their only option. In this context, there is an evident need for alternative treatments that can improve results. We present the case of a patient with a treatment-refractory hydatid cyst of the bone, who successfully underwent radiotherapy (RT).
A 64-year-old woman was diagnosed with a hydatid cyst of the bone in the sacroiliac joint that caused her sciatalgia and paresthesia. She underwent treatment with albendazole and surgery, and was treated with further doses of albendazole after relapsing six months later. After 2 years, she required a new resection, achieving a stable disease for 2 more years. At this point, she began to suffer from more intense pain (visual analogue scale 6/10). Given that further surgery was no longer feasible, she underwent radiotherapy (54 Gy in 27 fractions). No treatment-related toxicity was observed. At 1 month after radiotherapy, the pain had completely disappeared; 9 months later, the patient remains asymptomatic. The titer of anti-Echinococcus-granulosus antibodies and the absolute volume of eosinophils decreased after treatment with radiotherapy. The cyst remains radiologically stable.
Although further studies are needed, radiotherapy seems to be effective for hydatid cysts that are refractory to other treatments.
包虫病通常累及肝脏，但也可延伸至其他部位，如骨骼。在这些情况下，彻底切除骨骼被认为是唯一的治愈方法。然而，这很少可行，患者只能使用苯并咪唑类药物作为治疗选择。在这种情况下，显然需要能够改善治疗效果的替代疗法。我们报告了一例治疗抵抗性骨包虫囊肿患者，该患者成功接受了放射治疗（RT）。
一名 64 岁女性被诊断患有骶髂关节骨包虫囊肿，导致其坐骨神经痛和感觉异常。她接受了阿苯达唑治疗和手术治疗，6 个月后复发后又接受了进一步剂量的阿苯达唑治疗。2 年后，她需要再次切除，又实现了 2 年的稳定疾病状态。此时，她开始出现更剧烈的疼痛（视觉模拟评分 6/10）。由于进一步手术不再可行，她接受了放射治疗（54Gy，27 个分次）。未观察到与治疗相关的毒性。放射治疗后 1 个月，疼痛完全消失；9 个月后，患者仍无症状。抗包虫抗体滴度和嗜酸性粒细胞绝对值在放射治疗后下降。囊肿在影像学上保持稳定。
尽管需要进一步研究，但放射治疗似乎对其他治疗方法抵抗的包虫囊肿有效。
