高振华|王晋|尹军强|刘大伟|孟悛非. 四肢长骨骨巨细胞瘤刮除后两种植入材料的疗效对比[J]. 中国肿瘤临床, 2011, 38(16): 978-980. DOI: 10.3969/j.issn.1000-8179.2011.16.013
引用本文: 高振华|王晋|尹军强|刘大伟|孟悛非. 四肢长骨骨巨细胞瘤刮除后两种植入材料的疗效对比[J]. 中国肿瘤临床, 2011, 38(16): 978-980. DOI: 10.3969/j.issn.1000-8179.2011.16.013
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Zhenhua GAO. Comparison of the Therapeutic Outcomes of Two Implants in Curettage Treatment for Giant Cell Tumor of Long Extremity Bones[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(16): 978-980. DOI: 10.3969/j.issn.1000-8179.2011.16.013
Citation: Zhenhua GAO. Comparison of the Therapeutic Outcomes of Two Implants in Curettage Treatment for Giant Cell Tumor of Long Extremity Bones[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(16): 978-980. DOI: 10.3969/j.issn.1000-8179.2011.16.013
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四肢长骨骨巨细胞瘤刮除后两种植入材料的疗效对比

Comparison of the Therapeutic Outcomes of Two Implants in Curettage Treatment for Giant Cell Tumor of Long Extremity Bones

    摘要
  • 摘要: 比较四肢长骨初发非恶性骨巨细胞瘤（Jaffe病理学Ⅰ～Ⅱ级）刮除植骨术与刮除骨水泥填充术治疗的疗效。方法：分析2004年1月至2008年1月间本院收治经手术病理证实且随访36个月以上的64例初发四肢长骨非恶性骨巨细胞瘤病例，将其按病灶刮除后植入材料的不同分为2组，进行术后1年和3年疗效的评比。刮除植骨组38例：男17例、女21例，年龄19～59岁，平均29.0岁，Jaffe病理学Ⅰ级9例、Ⅱ级29例；刮除骨水泥填充组26例：男15例、女11例，年龄21～53岁，平均31.2岁，Jaffe病理学Ⅰ级5例、Ⅱ级21例。结果：根据Mankin疗效评定标准：Ⅰ～Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后1年复发率（7.7%）低于刮除植骨组（31.6%）（χ2=5.15，P<0.05），其中Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后1年复发率（9.5%）亦低于刮除植骨组（34.5%）（χ2=4.16，P<0.05）。Ⅰ～Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后3年复发率（15.4%）低于刮除植骨组（44.7%）（χ2=6.03，P<0.05），其中Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后3年复发率（14.3%）亦低于刮除植骨组（48.3%）（χ2=6.27，P<0.05）。结论：四肢长骨初发非恶性骨巨细胞瘤刮除骨水泥填充术后1年和3年疗效均优于刮除植骨术，在临床情况允许下可采用肿瘤刮除骨水泥填充术来治疗四肢长骨初发非恶性骨巨细胞瘤。

     

    Abstract: To compare the therapeutic outcomes of curettages with bone graft and with bone cement filling for initial non-malignant giant cell tumor (GCT; including Jaffe's pathological grade I and II) of long extremity bones. Methods: A retrospective review of treatment outcomes was performed in 64 patients with initial non-malignant GCTs of long extremity bones. These patients were treated in our hospital between January 2004 and January 2008. Their GCTs were proven by surgical pathology, and were followed up for more than 3 years. The patients were divided into 2 groups according to the treatment method. Group 1 consisted of 38 patients ( 17 males and 21 females ) who were 19 to 59 years old ( the mean age was 29.0 years old ). This group was treated by curettage of tumor and bone transplantation. By Jaffe's classification, 9 patients had Grade I GCT and 29 patients had Grade II. Group 2 consisted of 26 patients ( 15 males and 11 females ) who were 21 to 53 years old ( the mean age was 31.2 years old ). This group was treated by curettage of tumor and packing the cavity with bone cement. By Jaffe's classification, 5 patients had Grade I GCT and 21 patients had Grade II. Results: The therapeutic outcomes were evaluated according to Mankin's standard. For grades I and II GCT with curettage, the recurrence rate after 1 year in the bone cement packing group ( 7.7% ) was lower than that of the bone grafting group (31.6%) ( χ2 = 5.15, P < 0.05 ). The recurrence rates after 1 year of grade II GCT in the two groups were 9.5% and 34.5%, respectively. The differences were significant ( χ2 = 4.16, P < 0.05 ). For grades I and II GCT with curettage, the recurrence rate after 3 years in the bone cement packing group ( 15.4% ) was lower than that of the bone grafting group ( 44.7% ) (  χ2 = 6.03, P < 0.05 ). The recurrence rates after 3 years of grade II GCT in the two groups were 14.3% and 48.3%, respectively. The differences were significant ( χ2 = 6.27, P < 0.05 ). Conclusion: For curettaged initial non-malignant GCT of long bones, the 1- and 3-year therapeutic outcomes of bone cement treatment were better than those of bone graft treatment.

     

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