手术联合术后放疗对膝关节弥漫型色素沉着绒毛结节性滑膜炎的疗效分析

Efficacy of surgery combined postoperative conformal radiotherapy in treatment of knee diffuse joint pigmented villonodular synovitis

目的：探讨手术联合术后放疗治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎（DPVNS）的临床效果。方法：对19例经病理确诊并行手术切除的膝关节DPVNS患者术后行关节外放射治疗DT36.0Gy/18～20f。结果：术后随访5个月～10年,3例失访,16例均无复发,放疗皮肤反应Ⅰ度。术前Lysholm膝关节评分为（36.8±5.8）分,放疗后至末次随访Lysholm膝关节评分为（87.5±6.6）分,且术后联合放疗组复发率明显低于单纯手术组,差异具有统计学意义（P〈0.05）。结论：DPVNS患者术后辅以放射治疗可有效预防复发,且安全性好。

Objective： To study the clinical efficacy of surgery combined postoperative conformal radiotherapy in treatment of knee diffuse joint pigmented villonodular synovitis（ DPVNS）. Methods： All 19 patients with knee DPVNS were treated with conformal radiation after synovectomy,radiation was delivered using 6 MVX-ray with an total dose of 36Gy（ 18 ～ 20f）. Results： With an average follow-up of 6 years（ 6 months ～ 10 years）,local control was achieved in 100%（ 16 /16） of the patients except 3 patients were lost to follow-up. All the 16 patients（ 100%） were scored as excellent or good DPVNS-related function. There were grade 1 treatment-related skin complications. The preoperative Lysholm knee score were（ 36. 8 ± 5. 8） points,after radiotherapy to the last follow-up Lysholm knee score were（ 87. 5 ± 6. 6） points,and the recurrence rate of postoperative adjuvant radiotherapy group was obviously lower thaly surgery group,（ P〈0. 05）. Conclusion： Postoperative conformal radiation is effective and safe in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in DPVNS.