Radiotherapy for the Treatment of Giant Cell Tumor of the Spine: A Report of 3 Cases and Review of the Literature

脊椎巨細胞瘤的最佳治療在目前仍頗具挑戰性，手術切除是最優先選擇的治療方式，但是其可能造成脊髓傷害，也因此限制了手術的範圍。從2001至2003年我們共治療三例脊椎巨細胞瘤病患，他們皆接受部份腫瘤切除，再針對受影響的脊椎進行術後放射線治療，放射劑量為4500至6120cGy之間，三位病患都能承受整個治療過程，並且無嚴重性的副作用。目前有二例存活，且並無疾病復發證據，另外一例於治療後24個月，經磁振造影檢查證實為局部復發，該病患目前仍然存活且無明顯的臨床証狀。我們的經驗顯示，針對無法完全切除的腫瘤或開刀切除會造成嚴重器官傷害的病患，保守性手術合併輔助放射線治療是一個合理的選擇。雖然沒有明確的劑量與臨床反應關係，但是文獻中建議3500至4500cGy範圍之內的劑量是安全的，而且可以有效地控制脊椎巨細胞瘤。

關鍵字

巨細胞瘤；脊椎；放射線治療

並列摘要

Optimal treatment for giant cell tumors of the spine remains challenging. Surgical excision remains the initial treatment of choice, but the potential spinal cord injury may limit the extent of resection. Between 2001 and 2003, we report 3 patients diagnosed with giant cell tumor of spine treated with post-operative radiotherapy. Surgery consisted of subtotal resection of tumor. The involved vertebrae were then irradiated with doses ranging from 4500 to 6120 cGy. All patients tolerated the treatment well with no severe or chronic complications. Two of the 3 patients are alive with no evidence of disease. One is alive with recurrent disease upon regular MRI follow-up 24 months after treatment, although it is not clinically apparent. Our experience shown adjuvant radiotherapy after conservative surgery is a reasonable treatment alternative for tumors that cannot be completely excised or in which surgery would result in significant morbidity. Although there is no clear dose response, review of the literature suggest doses ranged from 3500 to 4500 cGy are safe and effective in controlling giant cell tumor.

並列關鍵字

Giant cell tumor ； Spine ； Radiation therapy

國際替代計量

Radiotherapy for the Treatment of Giant Cell Tumor of the Spine: A Report of 3 Cases and Review of the Literature

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