RADIATION-THERAPY OF GIANT-CELL TUMOR OF BONE - ANALYSIS OF 35 PATIENTS
RADIATION-THERAPY OF GIANT-CELL TUMOR OF BONE - ANALYSIS OF 35 PATIENTS
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DOI：
10.1016/0360-3016(86)90346-9
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发表时间：
1986-03-01
影响因子：
7
通讯作者：
GU, XZ
中科院分区：
文献类型：
--
作者：
CHEN, ZX;GU, DZ;GU, XZ
本文报告35例骨巨细胞瘤的治疗。10例患者采用手术后放射治疗。10例均治愈；8例生存5年以上，4例生存10年以上无复发。25例患者单独接受放射治疗。所有患者随访2 ~ 17年。3500rad以上的局部控制率为82% (14/17)；对于接受4000 rad以上的患者，局部控制率为85%（11/13）。其中13人活了5年以上，9人活了10年以上。我们的经验表明，手术和术后放疗产生最好的结果，这些结果比文献报道的要好。放射治疗的效果与外科手术相当。对于不适合手术的病变，或者那些如果尝试手术会导致致残的病变，放疗应该单独使用或与保守手术联合使用。单独放疗剂量为5000 ~ 6000 rad，术后放疗剂量为3000 ~ 4000 rad。建议使用超高压X射线（60Co或8mv X射线），但不建议使用正压X射线。高剂量的单一放射疗程优于低剂量的多个放射疗程。62%（15/24）的患者在治疗完成前就开始缓解疼痛。在74%（14/19）的患者中，肿瘤肿块直到放疗后6个月才消退。
This paper reports 35 patients treated for giant cell tumor of bone. Ten patients were treated by surgery followed by postoperative irradiation. All 10 were cured; eight have survived for more than 5 years and four for more than 10 years without recurrence. Twenty-five patients were treated by radiation alone. All patients were followed for 2 to 17 years. For those who received more than 3500 rad, the local control rate was 82% (14/17); for those who received more than 4000 rad, the local control rate was 85% (11/13). Thirteen have lived for more than 5 years and nine have lived for more than 10. Our experience reveals that surgery and postoperative radiation produce the best results, and that these results are better than those reported in the literature. The results of radiation along are comparable to that of surgery. For lesions not amenable to surgery, or those which would become crippling if surgery is attempted, radiation sould be used either alone or in combination with conservative surgery. The dose for radiation alone should be 5000 to 6000 rad and for postoperative radiation, 3000 to 4000 rad. Supervoltage X rays (60Co or 8 Mv X ray), but not orthovoltage X rays, are indicated. A single radiation course with higher dose is preferred to multiple courses with lower doses. In 62% (15/24) or patients, pain relief begins before treatment is completed. In 74% (14/19) of patients, the tumor mass will not resolve until the sixth month after radiation.