Abstract
Between 1985 and 1991, 52 patients were treated for diaphyseal bony metastases. The combination of surgery and radiotherapy achieved pain control for 75% of the patients, irrespective of the surgical or radiotherapeutic technique. Limb function was preserved in 83% of cases, whatever the site or type of fixation. In 31 patients treated by internal fixation followed by external radiotherapy, the same results were obtained with good fracture prophylaxis (4/33). The follow-up study showed one complete response, 10 cases with stable X-ray appearances and 4 cases of progressive disease, none of which were associated with a secondary fracture.
Résumé
De 1985 à 1991, 52 malades ont été traités au Centre Georges François-Leclerc pour des métastases osseuses des os longs. L'association chirurgie et irradiation permet d'obtenir un contrôle clinique de la douleur chez 75 % des patients, quel que soit le type d'intervention et le choix technique chirurgical ou de radiothérapie. La fonction du membre est conservée dans 83 % des cas, quel que soit le site osseux ou le matériel utilisé. Chez 31 malades qui ont bénéficié d'une séquence thérapeutique comportant un enclouage fasciculé suivi d'une radiothérapie externe complémentaire, les résultats sont identiques et une prévention satisfaisante du risque fracturaire (4/33 interventions) est assurée. L'analyse des paramètres para-cliniques de l'évolution permet de constater 1 réponse complète, 4 réponses partielles, 10 stabilisations radiologiques et 4 progressions de l'ostéolyse qui ne sont jamais associées à la survenue d'une fracture secondaire.
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Maingon, P., Badet, T., Perrin, M. et al. Evolution après traitement d'une métastase osseuse des os longs. Orthop Traumatol 4, 17–20 (1994). https://doi.org/10.1007/BF01806723
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DOI: https://doi.org/10.1007/BF01806723