地舒单抗辅助治疗难治性骨巨细胞瘤
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苏州大学附属第一医院

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Denosumab in the treatment of refractory giant cell tumor of bone
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the First Affiliated Hospital of Soochow University

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    摘要:[目的] 观察地舒单抗新辅助治疗在手术治疗难治性骨巨细胞瘤中的疗效。[方法] 回顾性分析2020年9月-2022年9月本科收治的12例难治性骨巨细胞瘤患者的临床资料,术前每周皮下注射地舒单抗注射液120mg,持续4周,观察临床及影像学结果。[结果] 所有患者均顺利完成手术,术中无神经、血管损伤等严重并发症。用药后肿瘤组织纤维化变韧呈灰白色,边界清晰,组织学染色显示局部可见少量破骨细胞样多核巨细胞。与用药前相比,用药后、术后3个月、末次随访时,VAS评分显著下降(P<0.05),SF-36评分显著增加(P<0.05)。影像方面,用药后肿瘤CT最大直径缩小为52.3±14.0mm(P<0.05),病灶边缘CT值增加为276.1±79.1HU(P<0.05),病灶中心CT值增加为97.1±20.0HU(P<0.05)。[结论] 地舒单抗可作为一种新辅助治疗手段来达到外科降级,促进肿瘤病灶彻底刮除,最大程度的保留正常骨骼结构,以满足术后功能康复。

    Abstract:

    Abstract:[Objective] To observe the efficacy of denosumab neoadjuvant therapy in the surgical treatment of refractory giant cell tumors of bone. [Methods] Twelve patients were retrospectively analyzed in our department from September 2020 to September 2022. A 120mg dose of desumumab injection was injected subcutively every week before surgery for 4 weeks. The clinical and radiographic outcomes were analyzed. [Results] All operations were finished successfully without serious complications, such as nerve or vascular injury. After preoperative adjuvant therapy with denosumab, intraoperative gross specimens showed toughened tumor tissue fibrosis and grayish white, with clear boundaries. Histological staining of tumor specimens after treatment showed a small number of local osteoclast-like multinucleated giant cells. Compared to before administration, the VAS scores were decreased (P<0.05) and the SF-36 scores were significantly increased (P<0.05) after administration, 3 months, and last follow-up. Radiographically, the maximum diameter in CT of the tumor after the medication was reduced to 52.3±14.0mm (P<0.05). The edge CT values after treatment were increased to 276.1±79.1HU (P<0.05), and the central CT values were increased to 97.1±20.0H (P<0.05). [Conclusions] Denosumab therapy can be used as a new adjuvant therapy to achieve surgical degradation and promote the complete curettage of tumor lesions, which can preserve the normal bone structure to the maximum extent to meet the postoperative functional rehabilitation.

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  • 收稿日期:2022-11-29
  • 最后修改日期:2023-09-17
  • 录用日期:2023-10-13
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