Liu H S, Wang J W
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Mar;21(1):37-43.
Giant cell tumor of bone is benign but locally aggressive neoplasm with a tendency for local recurrence. Although various treatment options have been utilized and reported, it remains a difficult therapeutic problem for the orthopedic surgeon.
We reviewed the results of the treatment of giant cell tumor of bone in 27 patients. Eleven patients were treated with extended curettage and burring then packing with cement, while 16 patients had wide resection and reconstruction.
At an average of 50 months after surgery, the recurrence rate of curettage was 27% and that of wide resection was 6.25%. Two of the three patients who had a recurrence after curettage were treated by a secondary curettage procedure and were later free of disease. Overall, the local control rate after second curettage and packing with cement was 90.9%. There was no infection in the curettage group but infection occurred in 3 patients of the resection group. Eight patients in the curettage group (80%) had an excellent functional result but only 2 patients in the resection group (13%) achieved an excellent result.
This study demonstrates that either curettage and packing with cement or wide resection are effective in treatment of giant cell tumor of bone. There is, however, a better functional result after curettage and packing with cement than following wide resection. We recommend curettage and cement packing for giant cell tumor of bone whenever it is technically feasible.
骨巨细胞瘤是一种良性但具有局部侵袭性的肿瘤，有局部复发的倾向。尽管已经采用并报道了各种治疗方法，但对于骨科医生来说，它仍然是一个棘手的治疗难题。
我们回顾了27例骨巨细胞瘤患者的治疗结果。11例患者接受了扩大刮除、磨钻，然后用骨水泥填充，而16例患者进行了广泛切除和重建。
术后平均50个月，刮除术的复发率为27%，广泛切除术的复发率为6.25%。刮除术后复发的3例患者中有2例接受了二次刮除术治疗，随后疾病缓解。总体而言，二次刮除并填充骨水泥后的局部控制率为90.9%。刮除术组无感染发生，但切除组有3例患者发生感染。刮除术组8例患者（80%）功能结果优良，而切除组只有2例患者（13%）获得优良结果。
本研究表明，刮除并填充骨水泥或广泛切除在治疗骨巨细胞瘤方面均有效。然而，刮除并填充骨水泥后的功能结果优于广泛切除后。只要技术可行，我们建议对骨巨细胞瘤采用刮除并骨水泥填充治疗。
