文章：

局部辅助治疗对骨良性及中间型肿瘤刮除术后效果影响的文献系统综述

Effect of Local Adjuvants Following Curettage of Benign and Intermediate Tumours of Bone: A Systematic Review of the Literature

原文发布日期：25 August 2023

DOI: 10.3390/cancers15174258

类型: Article

开放获取: 是

英文摘要：

Local adjuvants are used upon intralesional resection of benign/intermediate bone tumours, aiming at reducing the local recurrence (LR) rate. However, it is under debate whether, when and which local adjuvants should be used. This PRISMA-guideline based systematic review aimed to analyse studies reporting on the role of adjuvants in benign/intermediate bone tumours. All original articles published between January 1995 and April 2020 were potentially eligible. Of 344 studies identified, 58 met the final inclusion criteria and were further analysed. Articles were screened for adjuvant and tumour type, follow-up period, surgical treatment, and development of LR. Differences in LR rates were analysed using chi-squared tests. Altogether, 3316 cases (10 different tumour entities) were analysed. Overall, 32 different therapeutic approaches were identified. The most common were curettage combined with high-speed burr (n= 774; 23.3%) and high-speed burr only (n= 620; 18.7%). The LR rate for studies with a minimum follow-up of 24 months (n= 30; 51.7%) was 12.5% (185/1483), with the highest rate found in GCT (16.7%; 144/861). In comparison to a combination of curettage, any adjuvant and PMMA, the sole application of curettage and high-speed burr (p= 0.015) reduced the LR rate in GCT. The overall complication rate was 9.6% (263/2732), which was most commonly attributable to postoperative fracture (n= 68) and osteoarthritis of an adjacent joint during follow-up (n= 62). A variety of adjuvants treatment options are reported in the literature. However, the most important step remains to be thorough curettage, ideally combined with high-speed burring.

摘要翻译： 

局部辅助治疗常用于良性/中间型骨肿瘤的病灶内切除术后，旨在降低局部复发率。然而，关于是否应使用、何时使用以及使用何种局部辅助治疗仍存在争议。本项基于PRISMA指南的系统综述旨在分析探讨辅助治疗在良性/中间型骨肿瘤中作用的相关研究。1995年1月至2020年4月期间发表的所有原创性研究均可能符合纳入标准。在检索到的344项研究中，58项符合最终纳入标准并进入深入分析。研究筛选内容包括辅助治疗方式、肿瘤类型、随访周期、手术治疗方案及局部复发情况。局部复发率的差异采用卡方检验进行分析。共纳入3316例病例（涵盖10种不同肿瘤类型），识别出32种不同治疗方案。最常见的治疗方式为刮除术联合高速磨钻（774例，占23.3%）及单纯高速磨钻治疗（620例，占18.7%）。在至少随访24个月的研究中（30项，占51.7%），局部复发率为12.5%（185/1483），其中骨巨细胞瘤复发率最高（16.7%，144/861）。与刮除术联合辅助治疗及骨水泥填充的综合方案相比，单纯采用刮除术联合高速磨钻可显著降低骨巨细胞瘤的局部复发率（p=0.015）。总体并发症发生率为9.6%（263/2732），最常见并发症为术后骨折（68例）和随访期间邻近关节骨关节炎（62例）。文献报道了多种辅助治疗方案，但最关键的步骤仍是彻底的病灶刮除，理想情况下应联合高速磨钻使用。

原文链接：

Effect of Local Adjuvants Following Curettage of Benign and Intermediate Tumours of Bone: A Systematic Review of the Literature