Denosumab治疗膝周复发骨巨细胞瘤术后评价

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Abstract Objective To explore the surgical methods after treatment of recurrent bone giant cell tumor with Denosumab.Methods From February 2014 to December 2019，22 patients（9 males，13 females，11 distal femur，11 proximal tibia）with recurrent bone giant cell tumor of the knee were treated with Denosumab in our department.Theaverage age was (34.09±11.62)years (18~55 years).22 patients received 3 months of treatment with Denosumab(subcutaneous injection of 120 mg/times on 1，8，15，29 day and followed by 120 mg/month).22 patients were divided into 2 groups according to surgical methods.12 Patients underwent Intracapsular curettageandbone cement filling and internal fixation in group 1(7 cases of distal femur and 5 cases of proximal tibia).10 Patients underwent wide excision and prosthesis replacement in group 2(4 cases of distal femur and 6 cases of proximal tibia).Postoperative patients were followed up by DR，CT，MRI and local ultrasound.To observe the local recurrence of tumor，the function of the limb was evaluated using the MSTS score of the Musculoskeletal Tumor Society after operation and in three months after operation.Results There was no significant difference in the basic data of 22 patients.22 patients were followed up from 12 months to 48 months with anaverage follow-up of (26.77±9.19)months.The total recurrence rate of the two groups was 13.64% (3/22).There were 3 recurrent cases in group 1(2 cases of distal femur and 1 case of proximal tibia).The recurrence rate in group 1 was 25.00% (3/12).All the postoperative wounds healed in stage I，and there were no surgical complications.There were no recurrent cases in group 2.The recurrence rate in group 2 was 0 (0/10).One patient had vein thrombosis in popliteal vein in one week after operation.But thrombus disappeared after 2 weeks of thrombolysis.1 patient's wound had fat liquefaction.The wound had healed with debridement and suture.There were no related complications such as loosening and dislocation of prosthesis.The MSTS in Group 1 score was (28.17±1.11)and that in Group 2 was (26.70±0.95).The MSTS score in group 1 was significantly higher than that in group 2(P＜0.05).Conclusion Denosumab is an effective adjuvant therapy for recurrent bone giant cell tumor，and recurrence risk is higher after discontinuation of medication.Extensive excisionand prosthesis replacement are recommended to reduce the risk of local recurrence after treatment with Denosumab.

Key words： recurrent bone giant cell tumor denosumab curettage extensive excision

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2020/V26/I7/591

［1］Klenke FM，Wenger DE，Inwards CY，et al.Giant cell tumor of bone：risk factors for recurrence［J］.Clin Orthop Relat Res，2011(469)：591-599.
［2］Niu X，Zhang Q，Hao L，et al.Giant cell tumor of the extremity：retrospective analysis of 621 Chinese patients from one institution［J］.J Bone Joint Surg(Am)，2012，94(5)：461-467.
［3］Gouin F，Dumaine V.Local recurrence after curettage treatment of giant cell tumors in peripheral bones：retrospective study by the GSF-GETO(french sarcoma and bone tumor study groups)［J］.Orthop Traumatol Surg Res，2013，99(6 Suppl)：S313-S318.
［4］Zhen W，Yaotian H，Songjian L，et al.Giant-cell tumor of bone.The long-term results of treatment by curettage and bone graft［J］.J Bone Joint Surg(Br)，2004，86(2)：212-216.
［5］郭卫，李建民，沈靖南，等.骨巨细胞瘤临床循证诊疗指南［J］.中华骨与关节外科杂志，2018，11(4)：276-287.
［6］郭世炳，于秀淳，胡永成.Denosumab治疗骨巨细胞瘤的研究进展［J］.中华骨科杂志，2018，38(14)：889-896.
［7］Van der Heijden L，Dijkstra PDS，Blay JY.Giant cell tumour of bone in the denosumab era［J］.Eur J Cancer，2017(77)：75-83.
［8］Thomas D，Henshaw R，Skubitz K，et al.Denosumab in patients with giant-cell tumour of bone：an open-label，phase 2 study［J］.Lancet Oncol，2010，11(3)：275-280.
［9］Chawla S，Henshaw R，Seeger L，et al.Safety and efficacy of denosumab for adults and skeletally mature adolescents with giant cell tumour of bone：interim analysis of an open-label，parallel-group，phase 2 study［J］.Lancet Oncol，2013，14(9)：901-908.
［10］Rutkowski P，Ferrari S，Grimer RJ，et al.Surgical downstaging in an open-label phase Ⅱ trial of denosumab in patients with giant cell tumor of bone［J］.Ann Surg Oncol，2015，22(9)：2860-2868.
［11］Enneking WF，Dunham W，Gebhardt MC，et al.A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system［J］.Clin Orthop Relat Res，1993(286)：241-246.
［12］陈雁飞，夏军，王思群，等.复发性骨巨细胞瘤的手术治疗选择和随访结果［J］.中国矫形外科杂志，2011，19(4)：1171-1174.
［13］Siebenrock KA，Unni KK，Rock MG.Giant-cell tumor of bone metastasing to the lung：a long term follow-up［J］.J Bone Joint Surg(Br)，1998，80(1)：43-47.
［14］Prosser GH，Baloch KG，Tillman RM，et al.Does curettage without adjuvant therapy provide low recurrence rates in giant cell tumors of bone?［J］.Clin Orthop Relat Res，2005(435)：211-218.
［15］Dougall WC，Chaisson M.The RANK/RANKL/OPG triad in cancer-induced bone diseases［J］.Cancer Metastasis Rev，2006，25(4)：541-549.
［16］López-Pousa A，Broto JM，Garrido T，et al.Giant cell tumour of bone：new treatments in development［J］.Clin Transl Oncol，2015，17(6)：419-430.
［17］Mak IW，Evaniew N，Popovic S，et al.A translational study of the neoplastic cells of giant cell tumor of bone following neoadjuvant denosumab［J］.J Bone Joint Surg(Am)，2014，96(15)：e127.
［18］Lau CP，Huang L，Wong KC，et al.Comparison of the anti-tumor effects of denosumab and zoledronic acid on the neoplastic stromal cells of giant cell tumor of bone［J］.Connect Tissue Res，2013，54(6)：439-449.
［19］Traub F，Singh J，Dickson BC，et al.Efficacy of denosumab in joint preservation for patients with giant cell tumour of the bone［J］.Eur J Cancer，2016，59：1-12.
［20］何传春，李东奇，刘姝，等.地诺单抗治疗骨巨细胞瘤的研究进展［J］.中国肿瘤临床，2018，45(14)：750-754.
［21］徐强，李家祥，吴晓东，等.三种手术方式治疗四肢骨巨细胞瘤的临床疗效［J］.江苏医药.2019，45(1)：28-30.
［22］李勇，王保苍，闫明，等.人工补片重建髌韧带止点术后伸膝功能观察［J］.实用骨科杂志，2018，24(10)：943-945.