骨巨细胞瘤的治疗选择

目的：探讨手术和辅助治疗对骨巨细胞瘤的疗效影响。方法：对1994年～2005年间收治的42例骨巨细胞瘤进行回顾性分析。结果：42例均获随访，随访时间1年～11年，平均4．5年。刮除组肿瘤复发率为17．4％，术后功能恢复满意，瘤段切除组肿瘤复发率为15．8％，术后功能恢复较差。结论：病灶刮除术是治疗骨巨细胞瘤的首选术式，采用该术式辅助进行瘤腔肿瘤灭活处理和术后放疗，可获得较好的肿瘤控制和功能恢复。

Choices of Treatment for Giant Cell Tumors of Bones

Objective: To evaluate the efficacy of surgical procedure and adjunctive therapy in treatment of giant cell tumors of the bones.Methods: The records of 42 patients with giant cell tumors of bones,which were managed at our hospital between 1994 and 2005 were reviewed to evaluate the oncological and functional outcome after treatment with curettage or with resection.Results: All the patients were followed-up for one to eleven years and the mean duration of follow-up was four and a half years.The local recurrence rate was 17.4 % with good functional outcome in the 23 cases after treatment with curettage and bone grafting or cementing combined with one or two adjuvants,and 15.8 % with poor functional outcome in the 19 cases after treatment with resection without or with reconstruction.Conclusion: Curettage combined with adjunctive local application of iodine and ethanol cauterization and post-operative radiotherapy may be the first choice of treatment for giant cell tumors of bones because both good functional outcome and low recurrence rate can be expected with this regimen.