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Retrospective cohort study of 68 sacral giant cell tumours treated with nerve-sparing surgery and evaluation on therapeutic benefits of denosumab therapy.

68 例骶骨骨巨细胞瘤行保留神经手术治疗的回顾性队列研究及denosumab治疗疗效评价。

  • 影响因子:3.58
  • DOI:10.1302/0301-620X.102B2.BJJ-2019-0813.R1
  • 作者列表:"Lim CY","Liu X","He F","Liang H","Yang Y","Ji T","Yang R","Guo W
  • 发表时间:2020-02-01
Abstract

AIMS:To investigate the benefits of denosumab in combination with nerve-sparing surgery for treatment of sacral giant cell tumours (GCTs). METHODS:This is a retrospective cohort study of patients with GCT who presented between January 2011 and July 2017. Intralesional curettage was performed and patients treated from 2015 to 2017 also received denosumab therapy. The patients were divided into three groups: Cohort 1: control group (n = 36); cohort 2: adjuvant denosumab group (n = 9); and cohort 3: neo- and adjuvant-denosumab group (n = 17). RESULTS:There were 68 patients within the study period. Six patients were lost to follow-up. The mean follow-up was 47.7 months (SD 23.2). Preoperative denosumab was found to reduce intraoperative haemorrhage and was associated with shorter operating time for tumour volume > 200 cm3. A total of 17 patients (27.4%) developed local recurrence. The locoregional control rate was 77.8% (7/9) and 87.5% (14/16) respectively for cohorts 2 and 3, in comparison to 66.7% (24/36) of the control group. The recurrence-free survival (RFS) rate was significantly higher for adjuvant denosumab group versus those without adjuvant denosumab during the first two years: 100% vs 83.8% at one year and 95.0% vs 70.3% at two years. No significant difference was found for the three-year RFS rate. CONCLUSION:Preoperative denosumab therapy was found to reduce intraoperative haemorrhage and was associated with shorter operating times. Adjuvant denosumab was useful to prevent early recurrence during the first two years after surgery. Cite this article: Bone Joint J 2020;102-B(2):177-185.

摘要

目的: 探讨denosumab联合保留神经的手术治疗骶骨巨细胞肿瘤 (GCTs) 的益处。 方法: 这是一项 2011 年 1 月至 2017 年 7 月期间出现的GCT患者的回顾性队列研究。行病灶内刮除术,2015 年至 2017 年治疗的患者也接受denosumab治疗。将患者分为三组: 队列 1: 对照组 (n = 36); 队列 2: denosumab辅助组 (n = 9); 队列 3: 新辅助denosumab组 (n = 17)。 结果: 研究期间有 68 例患者。6 例患者失访。平均随访 47.7 个月 (SD 23.2)。术前denosumab被发现可减少术中出血,并与肿瘤体积> 200立方厘米的手术时间较短相关。共有 17 例患者 (27.4%) 发生局部复发。队列 2 和 3 的局部区域控制率分别为 77.8% (7/9) 和 87.5% (14/16),而对照组为 66.7% (24/36)。在前两年,辅助denosumab组的无复发生存率 (RFS) 显著高于未辅助denosumab组: 1 年 100% vs 83.8%,2 年 95.0% vs 70.3%。未发现三年RFS率存在显著差异。 结论: 发现术前denosumab治疗可减少术中出血,且手术时间较短。辅助denosumab可用于预防术后前两年的早期复发。引用本文: 骨关节J 2020;102-B(2):177-185。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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