镁基生物材料治疗骨肉瘤相关骨缺损的研究进展  

Research progress of magnesium-based biomaterials in the treatment of bone defects induced by osteosarcoma

作　　者：陈敬腾 余铃[1] 李时雨 郭卫春[1] Chen Jingteng;Yu Ling;Li Shiyu;Guo Weichun(Department of Spine Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院脊柱一科,武汉430060

出　　处：《中华骨科杂志》2025年第2期109-118,共10页Chinese Journal of Orthopaedics

摘　　要：骨肉瘤是最常见的儿童和青少年原发恶性骨肿瘤。发病高峰期为10~20岁,致死率及致残率极高;而在成人中,骨肉瘤是第三常见的骨肿瘤。尽管化疗、手术技术和放疗的改进使骨肉瘤的总体生存率显著提高,但患者的长期预后改善并不明显,特别是在肿瘤转移和复发的情况下。由于肿瘤细胞高度侵袭性生长,骨肉瘤进展常伴随对周围骨组织的破坏及新生不成熟骨的形成,其治疗难度较大,特别是在手术切除后的组织修复和功能恢复方面。肿瘤切除手术通常会造成广泛的骨组织丧失,尤其在涉及关节或负重部位时,重建骨结构和功能变得非常复杂。目前临床应用的不锈钢或钛合金假体等惰性材料生物相容性较差、弹性模量大,易引起假体松动及感染等问题。临床上亟须既能修复骨缺损又能抑制肿瘤复发的双功能生物材料。镁基生物材料有良好的生物降解性和生物活性,释放出的镁离子及降解产物能有效促进骨组织再生,并展现出抑制肿瘤的潜力。本文综述了镁基生物材料在骨肉瘤相关骨缺损治疗中的应用,包括在骨肉瘤微环境中适应酸性条件、促进骨形成的潜力以及抗肿瘤作用机制;分析了镁基材料的力学匹配性及涂层技术在提高抗腐蚀性能中的应用,探讨了不同类型镁基化合物在骨肉瘤相关骨缺损治疗中的应用前景。Osteosarcoma is the most common primary malignant bone tumor in children and adolescents with a peak incidence between the ages of 10 and 20.It has an extremely high mortality and disability rate.In adults,osteosarcoma is the third most common bone tumor.Despite the advances in chemotherapy,surgical techniques,and radiotherapy that have significantly improved the overall survival rate of osteosarcoma,the long-term prognosis of patients has not shown substantial improvement,especially in cases of tumor metastasis and recurrence.Due to the highly invasive growth of tumor cells,the progression of osteosarcoma is often accompanied by the destruction of surrounding bone tissue and the formation of immature new bone,making treatment challenging,especially in tissue repair and functional recovery following surgical resection.Tumor resection surgery often results in extensive bone loss,particularly in cases involving joints or weight-bearing areas,making the reconstruction of bone structure and function highly complex.Currently,inert materials such as stainless steel or titanium alloy prostheses used in clinical practice exhibit poor biocompatibility and high elastic modulus,often leading to prosthesis loosening and infection.There is an urgent clinical need for multifunctional biomaterials capable of both repairing bone defects and inhibiting tumor recurrence.Magnesium-based biomaterials have shown excellent biodegradability and bioactivity,and the release of magnesium ions and degradation products effectively promotes bone tissue regeneration while demonstrating potential antitumor effects.This paper reviews the application of magnesium-based biomaterials in the treatment of bone defects associated with osteosarcoma,including their adaptation to the acidic conditions of the osteosarcoma microenvironment,their potential to promote osteogenesis,and their antitumor mechanisms.It also analyzes the mechanical compatibility of magnesium-based materials and the use of coating technologies to enhance their corrosion resistance

关 键 词：镁 生物材料 骨肉瘤 骨缺损 治疗进展 

分 类 号：R738.1[医药卫生—肿瘤] R318.08[医药卫生—临床医学]