Department of Orthopedic Surgery, Kindai University Hospital, Osaka, Japan.
Medicine (Baltimore). 2022 Aug 12;101(32):e29963. doi: 10.1097/MD.0000000000029963.
There is no consensus on a treatment strategy for spinal giant cell tumor of bone (GCTB) because of the difficulty in their treatment. Treatment options often include the use of the controversial denosumab, an antibody therapy aimed at tumor shrinkage, different curettage techniques, resection, or a combination of these therapies. The current study aimed to identify treatment methods associated with favorable outcomes in patients with spinal GCTB. We retrospectively reviewed 5 patients with spinal GCTB, including patients with tumors of the sacrum, treated at our hospital between September 2011 and November 2020. Two men and 3 women were included in the study. The median follow-up period was 74 months (range: 14-108 months). We surveyed the tumor site, treatment method, denosumab use, and outcomes. The median age was 17 years (range: 17-42 years). There were 2 cases of sacral GCTB and 1 case each of lumbar, cervical, and thoracic vertebral GCTB. The comorbidities observed included hepatitis, malignant lymphoma, atopic dermatitis, and asthma. The treatment method included zoledronic acid after embolization and denosumab, denosumab only, curettage and posterior fusion, and curettage resection after embolization and anterior and posterior fusion. Denosumab was used in all cases. Three patients were continuously disease-free, 1 patient with no evidence of disease, and 1 patient alive with disease. Aggressive treatment, especially surgical treatment, may lead to good results in spinal GCTB.
对于骨巨细胞瘤(GCTB)的治疗,目前尚无共识,因为其治疗难度较大。治疗方案通常包括使用有争议的地舒单抗(一种旨在缩小肿瘤的抗体疗法)、不同的刮除技术、切除或这些疗法的联合应用。本研究旨在确定与脊柱 GCTB 患者良好结局相关的治疗方法。我们回顾性分析了 2011 年 9 月至 2020 年 11 月在我院治疗的 5 例脊柱 GCTB 患者,包括骶骨肿瘤患者。该研究纳入 2 例男性和 3 例女性患者,中位随访时间为 74 个月(范围:14-108 个月)。我们调查了肿瘤部位、治疗方法、地舒单抗的使用情况和结局。中位年龄为 17 岁(范围:17-42 岁)。其中 2 例为骶骨 GCTB,1 例为腰椎、1 例为颈椎和 1 例为胸椎 GCTB。观察到的合并症包括肝炎、恶性淋巴瘤、特应性皮炎和哮喘。治疗方法包括栓塞后唑来膦酸和地舒单抗、单纯地舒单抗、刮除和后路融合,以及栓塞后前路和后路切除。所有患者均使用了地舒单抗。3 例患者持续无病,1 例患者无疾病证据,1 例患者带瘤生存。积极治疗,特别是手术治疗,可能会给脊柱 GCTB 带来良好的结果。