中华骨与关节外科杂志

2018, 04, v.11 252-259+275

多发性骨髓瘤骨病外科治疗循证医学指南

郭卫² 牛晓辉³ 肖建如⁴ 李建民⁵ 王臻⁶ 沈靖南⁷ 邵增务⁸ 张伟滨⁹ 叶招明¹⁰ 吴苏稼¹¹ 屠重棋¹² 路瑾¹³ 陈文明¹⁴ 杜心如¹⁵ 杨毅²

1.中国医师协会骨科医师分会骨肿瘤工作委员会 2.北京大学人民医院骨肿瘤科 3.北京积水潭医院骨肿瘤科 4.上海长征医院骨科 5.山东大学齐鲁医院骨科 6.空军军医大学西京医院骨科 7.中山大学第一附属医院骨科 8.华中科技大学同济医学院附属协和医院骨科 9.上海瑞金医院骨科 10.浙江大学第二附属医院骨科 11.南京军区总医院骨科 12.四川大学华西医院骨科 13.北京大学人民医院血液科 14.北京朝阳医院血液科 15.北京朝阳医院骨科

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摘要：

大部分多发性骨髓瘤患者在病程中会出现骨髓瘤骨病,严重影响患者的生活质量和生存率。规范的化疗、靶向治疗和双膦酸盐是治疗多发性骨髓瘤骨病的基础和最重要的部分。外科手术在多发性骨髓瘤骨病急性并发症(病理性骨折、脊柱不稳和脊髓压迫症等)的治疗中发挥着重要作用。中国医师协会骨科医师分会骨肿瘤专业委员会依据循证医学方法制定了《多发性骨髓瘤骨病外科治疗循证医学指南》,分别就外科治疗时机、手术指征、不同部位的手术方式及综合治疗等临床问题进行总结,依据文献证据等级给出相应的推荐等级。专业委员会希望本指南能够为骨肿瘤医师的临床诊疗提供最佳的、有效的意见参考,从而使患者达到最佳的治疗效果。而本指南仅为学术性指导意见,具体实施时必须依据患者的个体医疗情况而定。

关键词： 多发性骨髓瘤骨病; 骨肿瘤; 外科治疗,指南;

Abstract：

Bone diseases would be developed in most patients with multiple myeloma(MM) during the course of disease,which severely jeopardize the quality of life and survival rates of the patients. Standardized chemotherapy, targeted therapy and bisphosphonates compose the fundamental treatments for MM, while surgical treatments play a critical role in the treatment for acute complications of bone diseases(e.g. pathological fracture, spinal instability, spinal cord compression). The Musculoskeletal Tumor Society from Chinese Association of Orthopaedic Surgeons proposes the "Guideline for evidencebased surgical treatment of multiple myeloma bone disease". This guideline addresses several clinical problems(e.g. timing for surgical treatments, indications for operations, surgical options for lesions of different locations, and multi-modality treatments) and provides recommendations with categories of evidence and consensus. The Society hopes that this guideline can provide the most effective references for practitioners of oncological orthopaedics in order to achieve the best outcomes for patients. But this guideline provides only academic recommendations and should be adapted to individualized treatments during clinical practice.

KeyWords： Multiple Myeloma Bone Disease; Bone Tumor; Surgical Treatment; Guidebooks;

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参考文献

[1]Lu J,Lu J,Chen W,et al.Clinical features and treatment outcome in newly diagnosed Chinese patients with multiple myeloma:results of a multicenter analysis.Blood Cancer J,2014,4:e239.

[2]Moreau P,Attal M,Facon T.Frontline therapy of multiple myeloma.Blood,2015,125(20):3076-3084.

[3]Croucher PI,Apperley JF.Bone disease in multiple myeloma.Br J Haematol,1998,103(4):902-910.

[4]Kyle RA,Gertz MA,Witzig TE,et al.Review of 1027 patients with newly diagnosed multiple myeloma.Mayo Clin Proc,2003,78(1):21-33.

[5]Terpos E,Dimopoulos MA.Myeloma bone disease:pathophysiology and management.Ann Oncol,2005,16(8):1223-1231.

[6]Raje N,Roodman GD.Advances in the biology and treatment of bone disease in multiple myeloma.Clin Cancer Res,2011,17(6):1278-1286.

[7]Coleman RE.Skeletal complications of malignancy.Cancer,1997,80(8 Suppl):1588-1594.

[8]Roodman GD.Novel targets for myeloma bone disease.Expert Opin Ther Targets,2008,12(11):1377-1387.

[9]Rajkumar SV,Dimopoulos MA,Palumbo A,et al.International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.Lancet Oncol,2014,15(12):e538-e548.

[10]Dimopoulos M,Terpos E,Comenzo RL,et al.International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple myeloma.Leukemia,2009,23(9):1545-1556.

[11]Terpos E,Moulopoulos LA,Dimopoulos MA.Advances in imaging and the management of myeloma bone disease.J Clin Oncol,2011,29(14):1907-1915.

[12]Regelink JC,Minnema MC,Terpos E,et al.Comparison of modern and conventional imaging techniques in establishing multiple myeloma-related bone disease:a systematic review.Br J Haematol,2013,162(1):50-61.

[13]Pianko MJ,Terpos E,Roodman GD,et al.Whole-body lowdose computed tomography and advanced imaging techniques for multiple myeloma bone disease.Clin Cancer Res,2014,20(23):5888-5897.

[14]Terpos E,Kleber M,Engelhardt M,et al.European Myeloma Network guidelines for the management of multiple myeloma-related complications.Haematologica,2015,100(10):1254-1266.

[15]Kastritis E,Moulopoulos LA,Terpos E,et al.The prognostic importance of the presence of more than one focal lesion in spine MRI of patients with asymptomatic(smoldering)multiple myeloma.Leukemia,2014,28(12):2402-2403.

[16]Moulopoulos LA,Dimopoulos MA,Christoulas D,et al.Diffuse MRI marrow pattern correlates with increased angiogenesis,advanced disease features and poor prognosis in newly diagnosed myeloma treated with novel agents.Leukemia,2010,24(6):1206-1212.

[17]Zamagni E,Patriarca F,Nanni C,et al.Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation.Blood,2011,118(23):5989-5995.

[18]Spinnato P,Bazzocchi A,Brioli A,et al.Contrast enhanced MRI and18F-FDG PET-CT in the assessment of multiple myeloma:a comparison of results in different phases of the disease.Eur J Radiol,2012,81(12):4013-4018.

[19]Kansara G,Hussain M,Dimauro J.A case of plasmacytoma in muscle as a complication of needle tract seeding after percutaneous bone marrow biopsy.Am J Clin Pathol,1989,91(5):604-606.

[20]Utzschneider S,Schmidt H,Weber P,et al.Surgical therapy of skeletal complications in multiple myeloma.Int Orthop,2011,35(8):1209-1213.

[21]中华医学会血液学分会.多发性骨髓瘤骨病诊治指南.中华血液学杂志,2011,32(10):721-723.

[22]Terpos E,Sezer O,Croucher P,et al.Myeloma bone disease and proteasome inhibition therapies.Blood,2007,110(4):1098-1104.

[23]Berenson JR,Lichtenstein A,Porter L,et al.Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma.Myeloma Aredia Study Group.N Engl J Med,1996,334(8):488-493.

[24]Rosen LS,Gordon D,Kaminski M,et al.Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma:a phase III,double-blind,comparative trial.Cancer J,2001,7(5):377-387.

[25]Morgan GJ,Davies FE,Gregory WM,et al.Effects of induction and maintenance plus long-term bisphosphonates on bone disease in patients with multiple myeloma:the Medical Research Council Myeloma IX Trial.Blood,2012,119(23):5374-5383.

[26]Fusco V,Rossi M,De Martino I,et al.Incidence of osteonecrosis of the jaw(ONJ)in cancer patients with bone metastases treated with bisphosphonates and/or denosumab:some comments and questions.Acta Clin Belg,2017,1-2.

[27]Hu K,Yahalom J.Radiotherapy in the management of plasma cell tumors.Oncology(Williston Park),2000,14(1):101-108,111;discussion 111-112,115.

[28]Matuschek C,Ochtrop TA,B?lke E,et al.Effects of Radiotherapy in the treatment of multiple myeloma:a retrospective analysis of a Single Institution.Radiat Oncol,2015,10:71.

[29]Lee JW,Lee JE.Local radiotherapy for palliation in multiple myeloma patients with symptomatic bone lesions.Radiat Oncol J,2016,34(1):59-63.

[30]Wernicke AG,Sabbas A,Kulidzhanov F,et al.A singledose conformal delivery of radiotherapy following osteoplasty:a novel approach to treatment of osteolytic metastasis in the setting of multiple myeloma.HSS J,2012,8(2):169-174.

[31]李西成,郭卫,杨荣利,等.多发性骨髓瘤的外科治疗探讨.中华外科杂志,2004,(1):48-51.

[32]张学伟,杜心如,陈文明.多发性骨髓瘤患者的手术治疗与预后分析.中国骨与关节杂志,2014,(7):501-506.

[33]国际骨髓瘤基金会中国多发性骨髓瘤工作组外科治疗专家.多发性骨髓瘤骨病外科治疗中国专家共识.中华骨科杂志,2016,36(4):193-199.

[34]Zeifang F,Zahlten-Hinguranage A,Goldschmidt H,et al.Long-term survival after surgical intervention for bone disease in multiple myeloma.Ann Oncol,2005,16(2):222-227.

[35]Kivioja AH,Karaharju EO,Elomaa I,et al.Surgical treatment of myeloma of bone.Eur J Cancer,1992,28A(11):1865-1869.

[36]Mavrogenis AF,Angelini A,Pala E,et al.The role of surgery for haematologic neoplasms of bone.Acta Orthop Belg,2012,78(3):382-392.

[37]陈杰,陶惠民,童培建,等.多发性骨髓瘤的外科治疗.实用肿瘤杂志,2007,22(1):40-44.

[38]杨毅,郭卫,杨荣利,等.股骨上段转移癌的外科分型与治疗策略.中华外科杂志,2013,51(5):407-412.

[39]Papagelopoulos PJ,Galanis EC,Greipp PR,et al.Prosthetic hip replacement for pathologic or impending pathologic fractures in myeloma.Clin Orthop Relat Res,1997,(341):192-205.

[40]Mirels H.Metastatic disease in long bones.A proposed scoring system for diagnosing impending pathologic fractures.Clin Orthop Relat Res,1989,(249):256-264.

[41]Zadnik PL,Goodwin CR,Karami KJ,et al.Outcomes following surgical intervention for impending and gross instability caused by multiple myeloma in the spinal column.J Neurosurg Spine,2015,22(3):301-309.

[42]Weber MH,Burch S,Buckley J,et al.Instability and impending instability of the thoracolumbar spine in patients with spinal metastases:a systematic review.Int J Oncol,2011,38(1):5-12.

[43]Tancioni F,Lorenzetti M,Navarria P,et al.Vertebroplasty for pain relief and spinal stabilization in multiple myeloma.Neurol Sci,2010,31(2):151-157.

[44]Papanastassiou ID,Eleraky M,Murtagh R,et al.Comparison of unilateral versus bilateral kyphoplasty in multiple myeloma patients and the importance of preoperative planning.Asian Spine J,2014,8(3):244-252.

[45]Orgera G,Krokidis M,Matteoli M,et al.Percutaneous vertebroplasty for pain management in patients with multiple myeloma:is radiofrequency ablation necessary?Cardiovasc Intervent Radiol,2014,37(1):203-210.

[46]施学东,米川,王冰,等.经皮微创骨水泥成形术治疗骨髓瘤骨病.中国临床实用医学,2015,(4):31-33.

[47]Berenson J,Pflugmacher R,Jarzem P,et al.Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer:a multicentre,randomised controlled trial.Lancet Oncol,2011,12(3):225-235.

[48]Jurczyszyn A,Czepko R,Banach M,et al.Percutaneous vertebroplasty for pathological vertebral compression fractures secondary to multiple myeloma--medium-term and long-term assessment of pain relief and quality of life.Adv Clin Exp Med,2015,24(4):651-656.

[49]王毅飞,郭卫,杨荣利,等.脊柱骨髓瘤的手术治疗效果及预后分析.中国脊柱脊髓杂志,2014,24(11):1001-1006.

[50]Dürr HR,Wegener B,Kr?del A,et al.Multiple myeloma:surgery of the spine:retrospective analysis of 27 patients.Spine(Phila Pa 1976),2002,27(3):320-324.

[51]Hong,B.,et al.Outcome of surgical decompression of spinal mass lesions in non-Hodgkin's lymphoma and plasmacytoma.Clin Neurol Neurosurg,2013,115(12):2476-2481.

[52]姜亮,袁伟,刘晓光,等.脊柱多发性骨髓瘤的诊断与治疗——附36例报告.中国脊柱脊髓杂志,2011,(7):540-544.

[53]Cai W,Yan W,Huang Q,et al.Surgery for plasma cell neoplasia patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation.Eur Spine J,2015,24(8):1761-1767.

[54]Kosaka N,Maeda M,Uematsu H,et al.Solitary plasmacytoma of the sacrum.Radiologic findings of three cases.ClinImaging,2005,29(6):426-429.

[55]Dmytriw AA,Talla K,Smith R.Percutaneous sacroplasty for the management of painful pathologic fracture in a multiple myeloma patient:Case report and review of the literature.Neuroradiol J,2017,30(1):80-83.

[56]Basile A,Tsetis D,Cavalli M,et al.Sacroplasty for local or massive localization of multiple myeloma.Cardiovasc Intervent Radiol,2010,33(6):1270-1277.

[57]Sakellariou VI,Mavrogenis AF,Savvidou O,et al.Reconstruction of multiple myeloma lesions around the pelvis and acetabulum.Eur J Orthop Surg Traumatol,2015,25(4):643-653.

[58]Wright JD,St Clair CM,Deutsch I,et al.Pelvic radiotherapy and the risk of secondary leukemia and multiple myeloma.Cancer,2010,116(10):2486-2492.

[59]Rock MG,Harrington K.Pathologic fractures of the acetabulum and the pelvis.Orthopedics,1992,15(5):569-576.

[60]Soutar R,Lucraft H,Jackson G,et al.Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma.Br J Haematol,2004,124(6):717-726.

[61]Li QW,Niu SQ,Wang HY,et al.Radiotherapy alone is associated with improved outcomes over surgery in the management of solitary plasmacytoma.Asian Pac J Cancer Prev,2015,16(9):3741-3745.

[62]Mendoza S,Urrutia J,Fuentes D.Surgical treatment of solitary plasmocytoma of the spine:case series.Iowa Orthop J,2004,24:86-94.

[63]Venkatesh R,Tandon V,Patel N,et al.Solitary plasmacytoma of L3 vertebral body treated by minimal access surgery:Common problem different solution!J Clin Orthop Trauma,2015,6(4):259-264.

[64]Finsinger P,Grammatico S,Chisini M,et al.Clinical features and prognostic factors in solitary plasmacytoma.Br J Haematol,2016,172(4):554-560.

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[1]郭卫,牛晓辉,肖建如等.多发性骨髓瘤骨病外科治疗循证医学指南[J].中华骨与关节外科杂志,2018,11(04):252-259+275.

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中华骨与关节外科杂志

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