关节镜联合放射治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎疗效观察

摘要

Objective To observe the therapeutic effects of arthroscopic synovectomy combined with postoperative three dimensional (3-D) conformal radiotherapy on knee joint diffuse pigmented villlonodular synovitits (DPVNS).Methods Eighteen patients with knee joint DPVNS were treated by 3-D conformal radiotherapy after arthroscopic synovectomy,in whom,16 patients were treated with dose of 36 Gy/18 F,however,the other two patients were treated with dose of 40 Gy/20 F.Results The 18 patients were followed up for 6~113 months(median time:49 months).The local control rate was 100% (18/18),and local relapse rate was 0%. The radiotherapy tolerance of patients was well,without ≥grade 2 acute/late radiation damage.Among 18 patients,there were 5 cases(28%) of excellent knee joint function and 13 cases(72%) of good knee joint function.Conclusion The postoperative 3-D conformal radiotherapy after arthroscopic synovectomy is effective and safe for patients with DPVNS,which can effectively prevent postoperative relapse.%目的 探讨膝关节弥漫性色素沉着绒毛结节性滑膜炎(DPVNS)患者关节镜术后联合三维适形放射治疗的疗效.方法 对18例经术后病理检查证实为DPVNS患者进行三维适形放疗,16例患者完成36 Gy/18 F,2例患者完成40 Gy/20 F.结果 随访6~113个月(中位时间49个月),18例患者局部控制率100%,局部复发率0;放疗耐受性良好,均未出现≥2级急性/晚期放射性损伤.膝关节功能评价优5例(28%),良13例(72%).结论 DPVNS患者关节镜滑膜切除术后,联合放射治疗36~40 Gy/18~20 F,安全有效,可有效预防术后复发.