目的:评价非手术治疗作为治疗中枢性巨细胞肉芽肿(CGCG)的替代方法的有效性。
方法:根据PRISMA声明进行了文献检索,以回答“非手术治疗在CGCG治疗中是否有效?”的问题。两名考官独立评估资格,偏见的风险,提取的数据,其中包括治疗方案,副作用,需要手术补充。
结果:在1712项研究中,包括15个,共有145名患者。降钙素,病灶内皮质类固醇,和denosumab是使用的药物。对于降钙素(n=61),30例完全缓解。对于病灶内曲安西龙(n=68),在大多数情况下观察到大小的减少(n=39)。4例接受皮下denosumab,显示该区域没有活跃的骨代谢,其中三人呈现骨化。在一项研究中报道了药物疗法的组合(n=29),包括皮下干扰素和口服伊马替尼。干扰素和皮质类固醇的副作用越来越少,分别。40%的患者需要额外的手术治疗。
结论:尽管出现了副作用,一些患者需要额外的手术,总的来说,所有非手术治疗都可以提供积极的结果,作为CGCG管理的替代方法,特别是关于减少病变的大小。
结论:CGCG是一种良性骨病变,主要影响年轻人。虽然最常见的治疗是手术,它在一些患者中的禁忌症,大的延伸,侵袭性变异的高复发率导致了对非手术疗法的寻找。
OBJECTIVE: To evaluate the effectiveness of non-surgical treatment as an alternative in the management of central giant cell granuloma (CGCG).
METHODS: A literature search was carried out in accordance with the PRISMA statement in order to answer the question \"Are non-surgical treatments effective as an alternative in the treatment of CGCG?\". Two examiners independently assessed eligibility, risk of bias, and extracted data, which included therapeutic protocol, side effects, and need for surgical supplementation.
RESULTS: Among 1712 studies, 15 were included, totaling 145 patients. Calcitonin, intralesional corticosteroids, and denosumab were the medications used. For calcitonin (n = 61), complete remission was found in 30 cases. For intralesional triamcinolone (n = 68), reduction in size was observed in most cases (n = 39). Four cases received subcutaneous denosumab and showed absence of active bone metabolism in the region, of which three presented ossification. Combination of drug therapies (n = 29) was reported in one study and included subcutaneous interferon and oral imatinib. More and less side effects were found for interferon and corticosteroids, respectively. Forty percent of patients required additional surgical treatment.
CONCLUSIONS: Despite the side effects presented and the need for additional surgery in some patients, in general, all non-surgical treatments could provide positive results as an alternative for the management of CGCG, especially with regard to reducing the size of the lesion.
CONCLUSIONS: CGCG is a benign bone lesion that mainly affects young individuals. Although the most common therapy is surgery, its contraindication in some patients, the large extension, and high recurrence rate of the aggressive variant have led the search for non-surgical therapies.