骨巨细胞瘤伴病理性骨折的治疗进展_West China Medical Journal

Authors：

 闵理 ,  屠重棋

四川大学华西医院骨科(成都, 610041);

Corresponding author：

屠重棋, Email: tuchongqi@163.com

Keywords：

骨巨细胞瘤; 病理性骨折; 刮除; 肿瘤人工假体; 同种异体骨

DOI：

10.7507/1002-0179.20140357

Video：

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Abstract Full text Figures/Tables Video References Cited by

病理性骨折是骨巨细胞瘤的一个重要并发症。目前，刮除灭活填充物填塞术与瘤段切除重建都是骨巨细胞瘤伴病理性骨折治疗的选择。但关于骨巨细胞瘤伴病理性骨折治疗方案的选择仍然存在争议。如何根据患者年龄、病理性骨折类型、软组织受累情况、骨质条件等情况，平衡复发率、术后关节功能、术后并发症之间的关系是治疗成败的关键。

Citation： 闵理, 屠重棋. 骨巨细胞瘤伴病理性骨折的治疗进展. 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.	Dreinhöfer 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. Dreinhöfer 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

骨巨细胞瘤伴病理性骨折的治疗进展

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