Recycling of extracorporeal irradiated autograft for treatment of limb bone tumor in children

Q4 Medicine 中华实用儿科临床杂志 Pub Date : 2020-03-30 DOI:10.3760/CMA.J.CN101070-20200316-00419

Xin Wang, Weitao Yao, Zhiyong Liu, Z. Tian, Po Li, Qiqing Cai

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引用次数: 0

Abstract

目的探讨瘤段骨体外射线灭活回植术在儿童四肢恶性/侵袭性骨肿瘤治疗中应用的安全性及有效性。方法 2016年6月至12月郑州大学附属肿瘤医院应用术中瘤段骨体外射线灭活回植术治疗儿童四肢骨肿瘤共8例，其中男4例，女4例；平均年龄12.75岁(11～14岁)。骨肉瘤6例，尤文氏肉瘤1例，反复复发的朗格汉斯组织细胞增生症1例。肿瘤位于股骨中下段4例，胫骨中上段2例，胫骨中段1例，肱骨中上段1例。瘤段骨切除平均长度23 cm(16～35 cm)，瘤段离体后应用直线电子加速器-X线给予一次性等中心对穿照射60 Gy，灭活后回植，应用钢板内固定重建。结果所有病例均获得有效随访，平均随访时间20.4个月(18～24个月)，截止末次随访，均无局部复发，1例术后6个月死于肺转移，1例术后12个月发现肺转移，目前带瘤存活，其余6例未发现转移。存活病例中除1例末次随访时灭活骨尚未完全愈合，其余6例均获得愈合，平均愈合时间8.7个月(6～11个月)，美国骨骼肌肉肿瘤协会功能评分(MSTS)平均24.3分(21～29分)。出现并发症3例，其中内固定断裂1例，膝关节强直2例，经再次手术后均获得满意效果。未发生感染、回植骨骨折、吸收、骨不愈合等。结论术中瘤段骨体外射线灭活回植是儿童四肢骨肿瘤切除后骨缺损重建的有效方式。

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体外辐照自体移植物再生治疗儿童肢体骨肿瘤

Objective: To investigate the safety and effectiveness of extracorporeal radiation inactivation and replantation of tumor bone in the treatment of malignant/invasive bone tumors in children's limbs. Method: From June to December 2016, Zhengzhou University Affiliated Cancer Hospital applied intraoperative external radiation inactivation and replantation of tumor bone segments to treat a total of 8 children with limb bone tumors, including 4 males and 4 females; The average age is 12.75 years (11-14 years old). There were 6 cases of osteosarcoma, 1 case of Ewing's sarcoma, and 1 case of recurrent Langerhans histiocytosis. There were 4 tumors located in the middle and lower femur, 2 in the middle and upper tibia, 1 in the middle tibia, and 1 in the middle and upper humerus. The average length of bone resection for the tumor segment is 23 cm (16-35 cm). After the tumor segment is detached, a single dose of isocenter penetrating radiation of 60 Gy is administered using a linear electron accelerator X-ray. After inactivation, it is replanted and reconstructed using steel plate internal fixation. All cases received effective follow-up, with an average follow-up time of 20.4 months (18-24 months). As of the last follow-up, there were no local relapses. One case died of lung metastasis 6 months after surgery, and one case was found to have lung metastasis 12 months after surgery. Currently, the tumor is still present and the remaining 6 cases have not been found to have metastasis. Among the surviving cases, except for one case where the inactivated bone had not fully healed at the last follow-up, the remaining 6 cases all achieved healing, with an average healing time of 8.7 months (6-11 months). The American Skeletal Muscle Tumor Association Functional Score (MSTS) averaged 24.3 points (21-29 points). Complications occurred in 3 cases, including 1 case of internal fixation fracture and 2 cases of knee joint ankylosis. After reoperation, satisfactory results were achieved. No infection, replanted bone fracture, resorption, bone non union, etc. occurred. Conclusion: Extracorporeal radiation inactivation and replantation of tumor segment bone during surgery is an effective method for bone defect reconstruction after limb bone tumor resection in children.

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来源期刊

中华实用儿科临床杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

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0.00%

发文量

14243

期刊介绍： Chinese Journal of Applied Clinical Pediatrics ( semi-monthly ) is a core journal of paediatrics under the supervision of China Association for Science and Technology, sponsored by Chinese Medical Association and undertaken by Xinxiang Medical College. Founded in 1986, it is openly circulated both at home and abroad. The journal has several columns, such as Expert Forum, Experimental Research and Paediatric Surgery, which are mainly for paediatric medical workers and medical researchers in hospitals. Its purpose is to reflect the new theories and technologies in paediatric medicine and scientific research at home and abroad, and to promote academic exchanges. Chinese Journal of Applied Clinical Pediatrics is a source journal of China Science Citation Database (CSCD), a core journal of Peking University, a source journal of Chinese science and technology paper statistics (China Science and Technology Core Journals), a core academic journal of RCCSE, a high-quality scientific and technical journal of China, a high-quality scientific and technical journal of China Association for Science and Technology, and a high-quality scientific and technical journal of China Biomedical Science and Technology Association. We have been published in China Biomedical Literature Database (SinoMed), China Knowledge Network, Wanfang Data Knowledge Service Platform, China Academic Journal Abstracts, Scopus Database, Chemical Abstracts (USA), Japan Science and Technology Agency (JSTA) Database, Copernicus Abstracts (Poland), Abstracts of the Centre for Agricultural and Biological Sciences (CABS) of the United Kingdom, Cambridge Scientific Abstracts ProQuest Database, WHO Medical Journal of the Western Pacific Region (WMPR), and WHO Medical Journal of the Western Pacific Region (WMPR) of the United States. We have been included in dozens of authoritative databases at home and abroad, such as WHO Western Pacific Region Index of Medicine (WPRIM), Ullrich's Guide to Periodicals, and so on.