Effect of denosumab combined with surgery on sacral giant cell tumor / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the clinical benefits of denosumab in treatment of sacral giant cell tumor of bone(GCTB) when used preoperatively or postoperatively along with surgery, and to analysis the improvement of sacral nerve function. Methods Thirty patients diagnosed as sacral GCTB in Musculoskeletal Tumor Center of Peking University People's Hospital from April 2014 to July 2016 were divided into control group (10 cases), post-operative group (9 cases), and neoadjuvant group (11 cases). Patients in the post-operative and neoadjuvant group were treated with 120 mg of subcutaneous denosumab every 4 weeks with loading doses on days 8 and 15 of the first cycle. Results Three patients in the control cohort 1 had recurrence (3/10), no recurrence occurred in the post-operative group (0/9), and 3 patients in the neoadjuvant group had recurrence(3/11).There were no significant differences in event-free survival(EFS) among the three groups (P = 0.133). The objective response rate (OTR) was 63.6 % (7/11) in the neoadjuvant group based on the RECIST 1.1 criteria for evaluating the efficacy of solid tumors. Five cases had significant pain improvement (defined 2 points improved) and had much better bladder and bowel functions. Four patients were able to have their indwelling catheters removed after neoadjuvant denosumab treatment. Conclusions Neoadjuvant therapy with denosumab can relieve the symptoms and neurologic deficits caused by nerve compression and can diminish the intraoperative blood loss. Surgical removal of the tumor is still the basic treatment of sacral GCTB.