骨巨細胞瘤伴病理性骨折的治療進展_West China Medical Journal

Authors：

 閔理 ,  屠重棋

四川大學華西醫院骨科(成都, 610041);

Corresponding?author：

屠重棋, Email: tuchongqi@163.com

Keywords：

骨巨細胞瘤; 病理性骨折; 刮除; 腫瘤人工假體; 同種異體骨

DOI：

10.7507/1002-0179.20140357

Video：

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病理性骨折是骨巨細胞瘤的一個重要并發癥。目前，刮除滅活填充物填塞術與瘤段切除重建都是骨巨細胞瘤伴病理性骨折治療的選擇。但關于骨巨細胞瘤伴病理性骨折治療方案的選擇仍然存在爭議。如何根據患者年齡、病理性骨折類型、軟組織受累情況、骨質條件等情況，平衡復發率、術后關節功能、術后并發癥之間的關系是治療成敗的關鍵。

Citation： 閔理, 屠重棋. 骨巨細胞瘤伴病理性骨折的治療進展. West China Medical Journal, 2014, 29(6): 1160-1162. doi: 10.7507/1002-0179.20140357 Copy

1.	Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis of two hundred and eighteen cases[J]. J Bone Joint Surg Am, 1970, 52(4): 619-664.
2.	Campanacci M, Baldini N, Boriani S, et al. Giant-cell tumor of bone[J]. J Bone Joint Surg Am, 1987, 69(1): 106-114.
3.	Turcotte RE, Wunder JS, Isler MH, et al. Giant cell tumor of long bone: a Canadian Sarcoma Group study[J]. Clin Orthop Relat Res, 2002, 397(397): 248-258.
4.	Trieb K, Bitzan P, Lang S, et al. Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy[J]. Eur J Surg Oncol, 2001, 27(2): 200-202.
5.	Werner M. Giant cell tumour of bone: morphological, biological and histogenetical aspects[J]. Int Orthop, 2006, 30(6): 484-489.
6.	Thomas DM, Skubitz KM. Giant cell tumour of bone[J]. Curr Opin Oncol, 2009, 21(4): 338-344.
7.	Dickson BC, Li SQ, Wunder JS, et al. Giant cell tumor of bone express p63[J]. Mod Pathol, 2008, 21(4): 369-375.
8.	Jeys LM, Suneja R, Chami G, et al. Impending fractures in giant cell tumours of the distal femur: incidence and outcome[J]. Int Orthop, 2006, 30(2): 135-138.
9.	Blackley HR, Wunder JS, Davis AM, et al. Treatment of giant-cell tumors of long bones with curettage and bone-grafting[J]. J Bone Joint Surg Am, 1999, 81(6): 811-820.
10.	Deheshi BM, Jaffer SN, Griffin AM, et al. Joint salvage for pathologic fracture of giant cell tumor of the lower extremity[J]. Clin Orthop Relat Res, 2007, 459(6): 96-104.
11.	Mcdonald DJ, Sim FH, Mcleod RA, et al. Giant-cell tumor of bone[J]. J Bone Joint Surg Am, 1986, 68(2): 235-242.
12.	O'donnell RJ, Springfield DS, Motwani HK, et al. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement[J]. J Bone Joint Surg Am, 1994, 76(12): 1827-1833.
13.	Dreinh?fer KE, Rydholm A, Bauer HC, et al. Giant-cell tumours with fracture at diagnosis. Curettage and acrylic cementing in ten cases[J]. J Bone Joint Surg Br, 1995, 77(2): 189-193.
14.	Errani C, Ruggieri P, Asenzio MA, et al. Giant cell tumor of the extremity: a review of 349 cases from a single institution[J]. Cancer Treat Rev, 2010, 36(1): 1-7.
15.	Ghert MA, Rizzo M, Harrelson JM, et al. Giant-cell tumor of the appendicular skeleton[J]. Clin Orthop Relat Res, 2002, 400(40): 201-210.
16.	Prosser GH, Baloch KG, Tillman RM, et al. Does curettage without adjuvant therapy provide low recurrence rates in giant-cell tumors of bone?[J]. Clin Orthop Relat Res, 2005, 435(435): 211-218.
17.	Tuli SM, Varma BP, Srivastava TP. Giant-cell tumour of bone[J]. Int Orthop, 1978, 2(3): 207-214.
18.	Klenke FM, Wenger DE, Inwards CY, et al. Giant cell tumor of bone: risk factors for recurrence[J]. Clin Orthop Relat Res, 2011, 469(2): 591-599.
19.	Arbeitsgemeinschaft Knochentumoren, Becker WT, Dohle J, et al. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy[J]. J Bone Joint Surg Am, 2008, 90(5): 1060-1067.
20.	Chanchairujira K, Jiranantanakorn T, Phimolsarnti R, et al. Factors of local recurrence of giant cell tumor of long bone after treatment: plain radiographs, pathology and surgical procedures[J]. J Med Assoc Thai, 2011, 94(10): 1230-1237.
21.	Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment and outcome of 214 cases[J]. J Cancer Res Clin Oncol, 2008, 134(9): 969-978.
22.	Kivioja AH, Blomqvist C, Hietaniemi K, et al. Cement is recommended in intralesional surgery of giant cell tumors: a Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years[J]. Acta Orthop, 2008, 79(1): 86-93.
23.	van der Heijden L, Dijkstra PD, Campanacci DA, et al. Giant cell tumor with pathologic fracture: should we curette or resect?[J]. Clin Orthop Relat Res, 2013, 471(3): 820-829.
24.	Biau D, Faure F, Katsahian S, et al. Survival of total knee replacement with a megaprosthesis after bone tumor resection[J]. J Bone Joint Surg Am, 2006, 88(6): 1285-1293.
25.	Kinkel S, Lehner B, Kleinhans JA, et al. Medium to long-term results after reconstruction of bone defects at the knee with tumor endoprostheses[J]. J Surg Oncol, 2010, 101(2): 166-169.
26.	Niu X, Zhang Q, Hao L, et al. Giant cell tumor of the extremity: retrospective analysis of 621 Chinese patients from one institution[J]. J Bone Joint Surg Am, 2012, 94(5): 461-467.
27.	Henderson ER, Groundland JS, Pala E, et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review[J]. J Bone Joint Surg Am, 2011, 93(5): 418-429.
28.	Jeys LM, Grimer RJ, Carter SR, et al. Periprosthetic infection in patients treated for an orthopaedic oncological condition[J]. J Bone Joint Surg Am, 2005, 87(4): 842-849.
29.	Shehadeh A, Noveau J, Malawer M, et al. Late complications and survival of endoprosthetic reconstruction after resection of bone tumors[J]. Clin Orthop Relat Res, 2010, 468(11): 2885-2895.
30.	Amanatullah DF, Clark TR, Lopez MJ, et al. Giant cell tumor of bone[J]. Orthopedics, 2014, 37(2): 112-120.
31.	Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system[J]. Clin Orthop Relat Res, 1993(286): 241-246.
32.	Gitelis S, Mallin BA, Piasecki P, et al. Intralesional excision compared with en bloc resection for giant-cell tumors of bone[J]. J Bone Joint Surg Am, 1993, 75(11): 1648-1655.
33.	Oda Y, Miura H, Tsuneyoshi M, et al. Giant cell tumor of bone: oncological and functional results of long-term follow-up[J]. Jpn J Clin Oncol, 1998, 28(5): 323-328.
34.	Saikia KC, Bhattacharyya TD, Bhuyan SK, et al. Local recurrences after curettage and cementing in long bone giant cell tumor[J]. Indian J Orthop, 2011, 45(2): 168-173.
35.	Kostenuik PJ, Nguyen HQ, Mccabe J, et al. Denosumab, a fully human monoclonal antibody to RANKL, inhibits bone resorption and increases BMD in knock-in mice that Express chimeric (murine/human) RANKL[J]. J Bone Miner Res, 2009, 24(2): 182-195.
36.	Thomas D, Henshaw R, Skubitz K, et al. Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study[J]. Lancet Oncol, 2010, 11(3): 275-280.

1. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis of two hundred and eighteen cases[J]. J Bone Joint Surg Am, 1970, 52(4): 619-664.
2. Campanacci M, Baldini N, Boriani S, et al. Giant-cell tumor of bone[J]. J Bone Joint Surg Am, 1987, 69(1): 106-114.
3. Turcotte RE, Wunder JS, Isler MH, et al. Giant cell tumor of long bone: a Canadian Sarcoma Group study[J]. Clin Orthop Relat Res, 2002, 397(397): 248-258.
4. Trieb K, Bitzan P, Lang S, et al. Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy[J]. Eur J Surg Oncol, 2001, 27(2): 200-202.
5. Werner M. Giant cell tumour of bone: morphological, biological and histogenetical aspects[J]. Int Orthop, 2006, 30(6): 484-489.
6. Thomas DM, Skubitz KM. Giant cell tumour of bone[J]. Curr Opin Oncol, 2009, 21(4): 338-344.
7. Dickson BC, Li SQ, Wunder JS, et al. Giant cell tumor of bone express p63[J]. Mod Pathol, 2008, 21(4): 369-375.
8. Jeys LM, Suneja R, Chami G, et al. Impending fractures in giant cell tumours of the distal femur: incidence and outcome[J]. Int Orthop, 2006, 30(2): 135-138.
9. Blackley HR, Wunder JS, Davis AM, et al. Treatment of giant-cell tumors of long bones with curettage and bone-grafting[J]. J Bone Joint Surg Am, 1999, 81(6): 811-820.
10. Deheshi BM, Jaffer SN, Griffin AM, et al. Joint salvage for pathologic fracture of giant cell tumor of the lower extremity[J]. Clin Orthop Relat Res, 2007, 459(6): 96-104.
11. Mcdonald DJ, Sim FH, Mcleod RA, et al. Giant-cell tumor of bone[J]. J Bone Joint Surg Am, 1986, 68(2): 235-242.
12. O'donnell RJ, Springfield DS, Motwani HK, et al. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement[J]. J Bone Joint Surg Am, 1994, 76(12): 1827-1833.
13. Dreinh?fer KE, Rydholm A, Bauer HC, et al. Giant-cell tumours with fracture at diagnosis. Curettage and acrylic cementing in ten cases[J]. J Bone Joint Surg Br, 1995, 77(2): 189-193.
14. Errani C, Ruggieri P, Asenzio MA, et al. Giant cell tumor of the extremity: a review of 349 cases from a single institution[J]. Cancer Treat Rev, 2010, 36(1): 1-7.
15. Ghert MA, Rizzo M, Harrelson JM, et al. Giant-cell tumor of the appendicular skeleton[J]. Clin Orthop Relat Res, 2002, 400(40): 201-210.
16. Prosser GH, Baloch KG, Tillman RM, et al. Does curettage without adjuvant therapy provide low recurrence rates in giant-cell tumors of bone?[J]. Clin Orthop Relat Res, 2005, 435(435): 211-218.
17. Tuli SM, Varma BP, Srivastava TP. Giant-cell tumour of bone[J]. Int Orthop, 1978, 2(3): 207-214.
18. Klenke FM, Wenger DE, Inwards CY, et al. Giant cell tumor of bone: risk factors for recurrence[J]. Clin Orthop Relat Res, 2011, 469(2): 591-599.
19. Arbeitsgemeinschaft Knochentumoren, Becker WT, Dohle J, et al. Local recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy[J]. J Bone Joint Surg Am, 2008, 90(5): 1060-1067.
20. Chanchairujira K, Jiranantanakorn T, Phimolsarnti R, et al. Factors of local recurrence of giant cell tumor of long bone after treatment: plain radiographs, pathology and surgical procedures[J]. J Med Assoc Thai, 2011, 94(10): 1230-1237.
21. Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment and outcome of 214 cases[J]. J Cancer Res Clin Oncol, 2008, 134(9): 969-978.
22. Kivioja AH, Blomqvist C, Hietaniemi K, et al. Cement is recommended in intralesional surgery of giant cell tumors: a Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years[J]. Acta Orthop, 2008, 79(1): 86-93.
23. van der Heijden L, Dijkstra PD, Campanacci DA, et al. Giant cell tumor with pathologic fracture: should we curette or resect?[J]. Clin Orthop Relat Res, 2013, 471(3): 820-829.
24. Biau D, Faure F, Katsahian S, et al. Survival of total knee replacement with a megaprosthesis after bone tumor resection[J]. J Bone Joint Surg Am, 2006, 88(6): 1285-1293.
25. Kinkel S, Lehner B, Kleinhans JA, et al. Medium to long-term results after reconstruction of bone defects at the knee with tumor endoprostheses[J]. J Surg Oncol, 2010, 101(2): 166-169.
26. Niu X, Zhang Q, Hao L, et al. Giant cell tumor of the extremity: retrospective analysis of 621 Chinese patients from one institution[J]. J Bone Joint Surg Am, 2012, 94(5): 461-467.
27. Henderson ER, Groundland JS, Pala E, et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review[J]. J Bone Joint Surg Am, 2011, 93(5): 418-429.
28. Jeys LM, Grimer RJ, Carter SR, et al. Periprosthetic infection in patients treated for an orthopaedic oncological condition[J]. J Bone Joint Surg Am, 2005, 87(4): 842-849.
29. Shehadeh A, Noveau J, Malawer M, et al. Late complications and survival of endoprosthetic reconstruction after resection of bone tumors[J]. Clin Orthop Relat Res, 2010, 468(11): 2885-2895.
30. Amanatullah DF, Clark TR, Lopez MJ, et al. Giant cell tumor of bone[J]. Orthopedics, 2014, 37(2): 112-120.
31. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system[J]. Clin Orthop Relat Res, 1993(286): 241-246.
32. Gitelis S, Mallin BA, Piasecki P, et al. Intralesional excision compared with en bloc resection for giant-cell tumors of bone[J]. J Bone Joint Surg Am, 1993, 75(11): 1648-1655.
33. Oda Y, Miura H, Tsuneyoshi M, et al. Giant cell tumor of bone: oncological and functional results of long-term follow-up[J]. Jpn J Clin Oncol, 1998, 28(5): 323-328.
34. Saikia KC, Bhattacharyya TD, Bhuyan SK, et al. Local recurrences after curettage and cementing in long bone giant cell tumor[J]. Indian J Orthop, 2011, 45(2): 168-173.
35. Kostenuik PJ, Nguyen HQ, Mccabe J, et al. Denosumab, a fully human monoclonal antibody to RANKL, inhibits bone resorption and increases BMD in knock-in mice that Express chimeric (murine/human) RANKL[J]. J Bone Miner Res, 2009, 24(2): 182-195.
36. Thomas D, Henshaw R, Skubitz K, et al. Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study[J]. Lancet Oncol, 2010, 11(3): 275-280.

West China Medical Journal

骨巨細胞瘤伴病理性骨折的治療進展

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