膝关节弥漫性巨细胞瘤手术放疗综合治疗疗效

目的探讨膝关节弥漫型巨细胞瘤手术联合放射治疗的效果,以提高对该病的认识和诊治水平。方法对我院1997年9月-2010年7月间收治的12例膝关节弥漫型巨细胞瘤手术联合放射治疗的疗效分析,所有患者均经关节镜手术,并经术后病理确诊。其中11例术后伤口愈合后行放射治疗（其中2例为术后复发再次术后放疗）,1例术后未放疗。放疗采用德国西门子直线加速器6MV-X线照射,对肉眼全切除患者照射剂量20 Gy/10次,对不全切除者30 Gy/15次,均为5次/周放疗。结果手术联合放射治疗的11例中,9例获得2～10年（平均5年）随访,均未见肿瘤复发及症状复发,关节功能恢复良好,Lysholm关节功能评分由术前平均53.7分增加到87.5分,未发现急性或迟发性放射并发症。本组中3例术后未及时放疗或未放疗的患者分别在术后3、6个月复发。结论膝关节弥漫型巨细胞瘤临床少见,术后易复发,具有潜在恶性。手术后适量放疗有明显的预防复发作用,疗效好,且无明显并发症。患者关节功能恢复良好。

Operation combined with radiotherapy as treatment for diffuse giant cell tumours of knee

Objective To investigate the effect of external beam radiotherapy as postoperative treatment of diffuse giant cell tumours of knee.Methods Nine of the 12 patients were treated by radiotherapy as postoperative from Sept.1997 to Jul.2010.One of them had recurred postoperatively in 3 months.The patients performed by 6MV-X rays.Total dose was 20-30 Gy/10-15 fractions.Results Eight of the 11 patients were followed up 60 months averagely（range from 3 to 120 months）.None of the patients had seen recurrence of the diseases.Lysholm score was improved from 53.7 to 87.5 in follow up.They had no acute adverse effects and late effects.Conclusion External beam radiotherpy was especially importent for the recurrence of DPVNS of the knee as postoperative treatment.All patients showed good-to-excellent fuctional and were able to return to their previous level of activity.