Effect of bisphosphonates on local recurrence of giant cell tumor of bone: a meta-analysis

Shi, Mude; Chen, Lei; Wang, Yangxin; Wang, Wei; Zhang, Yujie; Yan, Shigui

doi:10.2147/cmar.s187316

Cited by 10 publications

(11 citation statements)

References 42 publications

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“…There were no cases with malignant transformation. The difference between the effects of orthovoltage and megavoltage with respect to the local failure, as reported in previous studies was also discussed in this article, which varies from 7% to 30% with megavoltage and as high as 63% with orthovoltage [65] .…”

Section: Radiotherapymentioning

confidence: 52%

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Giant Cell Tumor of Bone, current treatments, and potential therapeutic alternatives

2020

AJOCRR

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Giant cell tumor of bone (GCTB) is a primary bone tumor, locally aggressive. For many, a GCTB is considered a tumor with an unpredictable behavior, particularly regarding recurrences, pulmonary implants, and the possibility of primary malignancy. In terms of risk of recurrence, it is known that it is associated with the type of treatment used initially for the GCTB. The greater the number or recurrences, the greater the risk of pulmonary implants, and the greater the risk of malignant degeneration. Therefore, much of the prognosis of this tumor could be related to the type of initial treatment. Hence the importance of the treatment theme. This review includes a comparison between the various modalities for treatment in GCTB, considering the advantages and disadvantages of each one. Existing GCTB treatments are not 100% safe and effective at the same time. and this is the reason why the search for other treatment modalities should continue to offer a better oncologic and functional outcome to patients. In the end of this review, based on research work, we also mention other possible therapeutic options that could be explored and used in the future for GCT treatment.

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Section: Radiotherapymentioning

confidence: 52%

“…The secondary effects reported with BPs in patients with GCTB were a decrease in calcium levels, jaw osteonecrosis, fever and digestive upset. [65] Apparently, the type of bisphosphonate and previous dental procedures, may act as precipitating factors for jaw osteonecrosis [66] .…”

Section: Bisphosphonatesmentioning

confidence: 99%

Giant Cell Tumor of Bone, current treatments, and potential therapeutic alternatives

2020

AJOCRR

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“…A recent meta-analysis showed bisphosphonate had beneficial effect on patients who underwent intralesional curettage. 11 However, Lipplaa et al reported adjuvant treatment with zoledronic acid did not decrease the recurrence rate of GCTB in the recent randomized control trial with 14 patients. 19 In our opinion, with the present evidence from the literature, an adequate intralesional tumor curettage is still the key in local tumor control and reducing LR in GCTB of extremities.…”

Section: Discussionmentioning

confidence: 95%

Local Recurrence After Minimally Invasive Curettage For Primary Giant Cell Tumor of Bone With Perioperative Bisphosphonate Is Comparable to Open Curettage: Retrospective Comparison With 9-Year Follow-Up

Lau

Wong

Chiu

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To compare the long-term oncological outcome of minimally invasive curettage (MIC) with conventional open curettage (OC). Methods: We studied patients with primary giant cell tumor of bone (GCTB) of extremities who underwent intralesional tumor curettage and cementation and perioperative bisphosphonates from February 2003 to June 2016. All cases were histology-confirmed diagnoses of GCTB. Recurrent GCTB, malignant GCTB, cases in the axial skeleton (pelvis and spine), or cases with bone grafting of the curetted cavity were excluded. The local recurrence-free (LR-free) estimates of the OC and MIC groups were compared. The hazard ratio of a local recurrence was calculated for the various factors of the patients, disease, and treatment. Results: At a mean follow-up of 8.8 years, the overall LR rate was 24.2% (8 out of 33 patients). There was no statistical difference in LR in MIC and OC groups (27.8 % vs 20%; P ¼ .6). The mean time to LR was 33.1 months (8 to 75). The operative time was comparable in both MIC and OC groups. None of the risk factors studied led to a significantly higher hazard of LR. Conclusion: At a long-term follow-up of 9 years, MIC showed similar LR-free survival to OC. Combining bisphosphonates and MIC with a less invasive approach showed reasonable LR-free survival in long-term follow-up.

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“…Bisphosphonates, like zoledronic acid (ZA), can be an option in the adjuvant setting. A recent meta-analysis of case-control studies showed that the use of adjuvant bisphosphonates in patients submitted to intralesional curettage may decrease local recurrence rates, independently of Campanacci staging [79]. In patients undergoing wide resection, bisphosphonates seem to have no benefit in local recurrence.…”

Section: Bisphosphonatesmentioning

confidence: 99%

Medical Therapy of Giant Cell Tumor of Bone

Lopes-Brás¹,

Fernandes²,

Casimiro³

et al. 2021

Recent Advances in Bone Tumours and Osteoarthritis

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Giant cell tumor of bone (GCTB) is mostly a benign disease of the bone, although with high local recurrence rate and potential for metastatic spread, namely to the lungs. It is also a locally aggressive tumor, associated with severe morbidity and functional impairment due to bone destruction. Treatment is therefore required and should be offered at an early stage to allow complete resection, minimizing functional sequelae and local recurrence. Surgical resection is the mainstay of treatment, often followed by intralesional adjuvant therapy. GCTB has a particular biology, in which RANKL represents a key factor in tumor pathogenesis, thus making this molecule a valuable therapeutic target. Monthly administration of denosumab, a fully human monoclonal antibody directed against RANKL, has been studied in several clinical trials and shown a high rate of local control with favorable safety profile. In this chapter, current medical management, ongoing studies, and future directions in GCTB will be discussed.

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Effect of bisphosphonates on local recurrence of giant cell tumor of bone: a meta-analysis

Cited by 10 publications

References 42 publications

Giant Cell Tumor of Bone, current treatments, and potential therapeutic alternatives

Giant Cell Tumor of Bone, current treatments, and potential therapeutic alternatives

Local Recurrence After Minimally Invasive Curettage For Primary Giant Cell Tumor of Bone With Perioperative Bisphosphonate Is Comparable to Open Curettage: Retrospective Comparison With 9-Year Follow-Up

Medical Therapy of Giant Cell Tumor of Bone

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