Treatment of diffuse pigmented villonodular synovitis of the knee with combined surgical and radiosynovectomy.
Treatment of diffuse pigmented villonodular synovitis of the knee with combined surgical and radiosynovectomy.
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DOI：
10.1007/s11420-008-9104-5
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发表时间：
2009-02-01
期刊：
影响因子：
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通讯作者：
Elghazaly, Hesham A
中科院分区：
文献类型：
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作者：
Nassar, Wael A M;Bassiony, Ayman Abdelaziz;Elghazaly, Hesham A
通过孤立手术切除治疗大关节广泛弥漫性色素沉着绒毛结节性滑膜炎（PVNS）的效果并不令人满意，且局部复发率很高。滑膜切除术后辅助治疗采用外照射放射治疗或关节内注射放射性物质钇90 ((90)Y)可取得更好的效果。 2005年1月至2007年1月期间，12名患有广泛弥漫性膝关节PVNS的患者（8名男性和4名女性，年龄19-49岁）接受了治疗。所有患者均接受术后辅助外照射放射治疗（2,600-3,000 cGy），常规分次200 cGy/次，每周5次，术后6-8周。平均随访时间为 27 个月（范围为 20 至 36 个月）。所有患者均通过临床评估、磁共振成像和 X 线平片进行随访。在所有患者中，均未发现疾病复发或骨或关节破坏进展的证据。手术后或术后外照射放射治疗后未发现并发症。对于膝关节广泛弥漫性PVNS，采用前后路减灭手术与辅助术后外照射放射治疗相结合是一种可靠的治疗方法，在局部复发发生率和功能结果方面具有良好的效果。
Treatment of extensive diffuse pigmented villonodular synovitis (PVNS) of large joints by isolated surgical resection is unsatisfactory, with high rates of local recurrence. Post-synovectomy adjuvant treatment with external beam radiation therapy or intra-articular injection of radioactive material as yttrium-90 ((90)Y) yielded better results. Between January 2005 and January 2007, 12 patients (eight men and four women aged 19-49 years) with extensive diffuse PVNS of the knee were treated. All patients had an adjuvant post-operative external beam radiation therapy (2,600-3,000 cGy) conventionally fractionated 200 cGy/fraction, five fractions/week, 6-8 weeks after surgery. Mean follow-up time was 27 months (range from 20 to 36 months). All patients were followed up using clinical assessment, magnetic resonance imaging, and plain X-ray. In all patients, neither evidence of disease recurrence nor progression of bone or articular destruction was noted. No complications were noticed after surgery or after post-operative external beam radiation therapy. A combination of debulking surgery using anterior and posterior approach with adjuvant post-operative external beam radiation therapy for extensive diffuse PVNS of the knee joint is a reliable treatment method, with good results in regard to the incidence of local recurrence and functional outcome.