单纯关节镜术后适形放疗对膝关节弥漫型色素沉着绒毛结节性滑膜炎的临床疗效

Clinical Study on Efficacy of Arthroscopic Synovectomy and Combined Postoperative Conformal Radiotherapy in Treatment of Knee Diffuse Joint Pigmented Villonodular Synovitis

目的探讨单纯关节镜术后适形放疗治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的临床疗效。方法对8例经手术病理检查证实的首诊DPVNS患者进行三维适形治疗,其中镜下残留(R1)6例,肉眼残留(R2)2例,7例患者完成DT30.6 Gy/17次,1例患者DT27 Gy/15次。结果随访6~30个月(中位时间20个月),8例患者放疗耐受情况良好,放疗皮肤反应Ⅰ度(RTOG/EORTC分级标准),局部控制率100%。膝关节功能评分:优4例,良4例。结论DPVNS患者术后辅以放射治疗可有效预防DPVNS复发,且安全性好。

Objective To study the clinical efficacy of arthroscopic synovectomy and combined conformal radiation ther -apy in the treatment of keen diffuse pigmented villonodular synovitis (DPVNS).Methods 8 patients with knee DPVNS were treated with conformal radiation after arthroscopic synovectomy ,8 patients had residual tissue,which was microscopic(R1) in 6 patients(75.0%) and macroscopic(R2) in 2 patients(25.0%).Radiation was delivered using 6 MV X-ray with an total dose of 30.6 Gy (except one patient with total dose of 27 Gy).Results With an average follow-up of 20 months (range,6 ~30 months),local control was achieved in 100%(8/8) of the patients.All the 8 patients (100%) were scored as excellent or good DPVNS-related function .There were grade 1 treatment-related skin complications .Conclusion Postoperative conformal radiation is effective and safe in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local con -trol in DPVNS.