Körholz D, Wirtz I, Vosberg H, Rüther W, Jürgens H, Göbel U
Department of Paediatric Haematology and Oncology, Heinrich-Heine University Medical Center, Düsseldorf, Germany.
Eur J Cancer. 1996 Mar;32A(3):461-4. doi: 10.1016/0959-8049(95)00587-0.
The role of bone scintigraphy in the follow-up of osteosarcoma patients is still controversial. It is not yet clear whether bone scintigraphy results in early detection of relapse nor whether this can improve the survival rate of relapsed patients. In this study, results of scintigraphies obtained from 78 patients treated for osteosarcoma between 1978 and 1992 were analysed. 28/78 patients presented with 61 relapse sites, including 34 lung metastases, 20 distant relapses and 7 local recurrences. More than 90% of relapses were detected within 4 years after primary diagnosis of the tumour. A total of 489 bone scintigraphies were performed routinely during follow-up of these patients. 66/489 scintigraphies showed increased uptake of tracer. In 7/66 positive scintigraphies, a relapse was detected: lung metastases (3), local recurrence (1) and distant bone or soft tissue relapses (3). These relapses occurred between 1 and 4 years after primary diagnosis. In these cases, scintigraphies showed areas with increased uptake, although these patients had neither clinical symptoms nor positive X-rays or CT scans. At an observation period of 2.5 or 3.5 years, a second or third remission was induced in 2/6 patients in whom scintigraphy allowed an early diagnosis of the relapse. In conclusion, these data show that only a small number of routinely performed bone scintigraphies indicate a relapse. However, since bone scintigraphy is able to detect relapses early, the outcome of future relapsed patients might be improved. Therefore, bone scintigraphies should be included in a follow-up programme for patients with osteosarcoma. Since most relapses detected by scintigraphy occurred during the first 4 years after initial diagnosis, bone scintigraphy should be limited to this time frame.
骨闪烁扫描术在骨肉瘤患者随访中的作用仍存在争议。目前尚不清楚骨闪烁扫描术能否早期发现复发，也不清楚这是否能提高复发患者的生存率。在本研究中，分析了1978年至1992年间接受骨肉瘤治疗的78例患者的闪烁扫描结果。78例患者中有28例出现61个复发部位，包括34个肺转移、20个远处复发和7个局部复发。超过90%的复发在肿瘤初次诊断后的4年内被检测到。在这些患者的随访期间共进行了489次常规骨闪烁扫描。489次闪烁扫描中有66次显示示踪剂摄取增加。在66次阳性闪烁扫描中，有7次检测到复发：肺转移（3例）、局部复发（1例）和远处骨或软组织复发（3例）。这些复发发生在初次诊断后的1至4年。在这些病例中，闪烁扫描显示摄取增加区域，尽管这些患者既没有临床症状，X线或CT扫描也未显示阳性结果。在2.5年或3.5年的观察期内，在6例闪烁扫描能早期诊断复发的患者中，有2例诱导出第二次或第三次缓解。总之，这些数据表明，只有少数常规进行的骨闪烁扫描显示复发。然而，由于骨闪烁扫描术能够早期检测到复发，未来复发患者的预后可能会得到改善。因此，骨闪烁扫描术应纳入骨肉瘤患者的随访计划。由于闪烁扫描检测到的大多数复发发生在初次诊断后的前4年内，骨闪烁扫描应限于此时间段。
