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.