脊柱骨巨细胞瘤的诊断与治疗进展

Diagnosis and management of giant cell tumor of bone in the spine: a brief review

脊柱骨巨细胞瘤(giant cell tumor of bone,GCTB)较为少见,诊断依靠临床、影像和病理三结合原则。脊柱GCTB的治疗难度较大,目前还没有基于循证医学的治疗流程和共识,因而具有很强的挑战性。手术仍然是脊柱GCTB治疗的首选方法,术前选择性动脉栓塞、完整切除肿瘤及术后辅助使用地诺单抗(denosumab)是目前推荐的综合治疗方法。整块切除是脊柱GCTB的理想治疗方式,但手术方法的选择需要遵循个体化原则,根据不同的部位制定不同的手术方案。地诺赛麦对于手术无法完全切除、复发及转移性GCTB的治疗具有一定的优势,术前使用能够有效降低GCTB外科分期,并为整块切除手术创造条件,具有广泛的应用前景。

Giant cell tumors of bone(GCTB)in the spine are rarely seen,and the diagnosis relies on clinical presentations,imaging and pathology.The treatment of spinal giant cell tumor is difficult because there is no evidencebased management guidelines and consensus.Surgery is still the first choice for management of the spinal giant cell tumor.Preoperative arterial embolization and complete surgical removal with postoperative denosumab are the recommended treatment methods.En bloc resection is an ideal treatment for spinal giant cell tumors,but surgeons must carefully evaluate patients individually.Denosumab is indicated for patients with unresectable/recurrent/metastatic GCTB.It can effectively reduce the stage of giant GCTB and create conditions for en bloc resection.