骨巨细胞瘤治疗进展

骨巨细胞瘤是一种局部具有侵袭性、溶骨活性的良性骨肿瘤,传统治疗手段为囊内刮除植骨,但有很高的局部复发率,通过辅助手段对瘤腔进行处理,有效降低了局部复发;对于不同部位骨巨细胞瘤应依据病变部位、大小、侵犯范围、复发率的高低可选择不同的手术方法,包括假体置换、广泛切除、En bloc切除等;对于特殊部位预计手术风险大、不能完整切除患者可行动脉栓塞,有利于病情得到控制或手术;双磷酸盐、地诺单抗的应用给骨巨细胞瘤的治疗带来新的希望,可有效降低肿瘤复发,目前主要应用于复发、难治、特殊部位、转移性骨巨细胞瘤的治疗。化疗主要应用于转移、恶性骨巨细胞瘤的治疗,放疗对于复发或难以手术切除部位骨巨细胞瘤可控制肿瘤进展,但有恶变可能。双磷酸盐、地诺单抗缺乏长期随访,远期疗效尚不明确,骨巨细胞瘤治疗领域新方法、新药的研发为其带来了更多希望。

Treatment progress on giant cell tumors of bone

Giant cell tumors(GCT) of bone is benign bone tumors with aggressive and osteolytic activity. As traditional treatment of GCT,removal of bone graft is disease with high local recurrence rate,and could reduce local recurrence by auxiliary means. Different surgical methods such as prosthesis replacement,wide resection and En-bloc resection could be selected for different parts of giant cell tumor of bone,based on the lesion location,size,extent of invasion,recurrence rate. For patients with special region of GCT of bone with removed incompletely and high surgical risk expected,arterial embolism could be performed. The application of bisphosphonates and denosumab are mainly used in treating recurrent,refractory,special parts,metastatic giant cell tumor of bone will bring new hope of treatment for giant cell tumor of bone,due to lower the recurrence rate. Chemotherapy is mainly used in the treatment of metastasis and malignant bone tumor. Radiotherapy for recurrent or unresectable bone giant cell tumor can control tumor progression,but there is the possibility of malignancy. While long-term follow-up studies and long-term results of applications of bisphosphonates and denosumab are lacking,new methods and development of new drugs are still be needed to treat patients with giant cell tumor of bone and also bring about more hope.