针对无法切除的脊柱成骨性肉瘤的有意Enneking-不适当手术和高能粒子疗法:一项回顾性研究。

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of neurosurgery. Spine Pub Date : 2024-09-27 Print Date: 2024-12-01 DOI:10.3171/2024.5.SPINE231401
Gisberto Evangelisti, Luigi Falzetti, Franziska C S Altorfer, Stefano Bandiera, Giovanni Barbanti Brodano, Marco Cianchetti, Maria R Fiore, Emanuela Palmerini, Joseph H Schwab, Stefano Boriani, Alessandro Gasbarrini
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引用次数: 0

摘要

研究目的本研究旨在比较椎管内大体全切除术(GTR)后高能粒子疗法与整体切除术和椎管内切除术的疗效:方法:对2009年至2020年间确诊的脊柱原发性成骨性肉瘤(OGS)患者进行回顾性研究。研究收集了患者的人口统计学信息,包括年龄、患病部位、肿瘤体积和 Weinstein-Boriani-Biagini 分期。此外,还收集了诊断时的转移情况、住院时间、手术时间、并发症、计划中的手术治疗和放疗等信息。采用卡普兰-梅耶曲线比较了包括局部复发(LR)和疾病特异性生存(DSS)在内的结果指标:共纳入 20 名患者,中位年龄为 38 岁(IQR 23-60 岁)。中位随访时间为 15.7(IQR 6.3-36.9)个月。8名患者接受了全块切除术,LR率为38%(3名患者),中位DSS为26.4个月。四名患者在计划进行 GTR 后接受了高能粒子辅助治疗。他们的中位随访时间为 36 个月;这些患者均未发生 LR。1年和3年的DSS均为100%。另有 8 名患者接受了腔内切除术。8 名患者中有 6 名(75%)死于疾病,中位生存期为 7.3 个月(IQR 4.7-14 个月):GTR联合高能粒子辅助治疗似乎是脊柱OGS患者在无法进行整块切除时的一种安全有效的替代方法。结果显示,3年DSS为100%,且无重大手术并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intentional Enneking-inappropriate surgery and high-energy particle therapy for unresectable osteogenic sarcoma of the spine: a retrospective study.

Objective: The aim of this study was to compare the outcome of intralesional gross-total resection (GTR) followed by high-energy particle therapy with en bloc and intralesional resections.

Methods: A retrospective study of patients diagnosed with primary osteogenic sarcoma (OGS) of the spine between 2009 and 2020 was conducted. Demographic information, including age, affected site, tumor volume, and Weinstein-Boriani-Biagini stage, was collected. Additionally, information on metastases at diagnosis, length of stay, operating time, complications, planned surgical treatment, and radiotherapy was also collected. Outcome measures, including local recurrence (LR) and disease-specific survival (DSS), were compared using Kaplan-Meier curves.

Results: In total, 20 patients with a median age of 38 (IQR 23-60) years were included. The median follow-up was 15.7 (IQR 6.3-36.9) months. Eight patients underwent en bloc resection with a 38% (3 patients) LR rate and a median DSS of 26.4 months. Four patients received adjuvant high-energy particle therapy after planned GTR. Their median follow-up was 36 months; none of these patients experienced LR. Both the 1-year and 3-year DSSs were 100%. Another 8 patients underwent intralesional resection. Six of the 8 patients (75%) died of their disease, with a median survival of 7.3 (IQR 4.7-14) months.

Conclusions: GTR combined with adjuvant high-energy particle therapy appears to be a safe and effective alternative approach for patients with OGS of the spine when en bloc resection is not feasible. The results demonstrated a 3-year DSS of 100% and no major surgical complications.

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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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