Veng Christian, Jørgensen Peter Holmberg, Krog-Mikkelsen Inger, Stilling Maiken
Department of Orthopedic Surgery, Holstebro Regionshospital, Holstebro, Region Midtjylland, Denmark.
Department of Orthopedic Surgery, Aarhus Universitetshospital, Aarhus, Region Midtjylland, Denmark.
BMJ Case Rep. 2017 Oct 23;2017:bcr-2017-220369. doi: 10.1136/bcr-2017-220369.
Three patients with giant cell tumour of bone (GCTB) in the lower extremity, where the only surgical treatment options were amputation or severe weakening of the bone, were treated with denosumab (D-mab) to strengthen the bone mass in the tumour. In order to quantify changes in bone mineral density (BMD) in the GCTB lesion during D-mab treatment, we did repeated dual-energy X-ray absorptiometry (DXA) scans. The patients underwent operation after 3, 4 and 8 months of D-mab treatment, respectively. The tumours in all three patients responded markedly to D-mab, and up to 50% BMD increase was observed. There was almost no BMD change in the control scans in the hip and spine of the same patients. DXA scans provide no information about local tumour response, but may be of value in evaluation of the time and size of the D-mab response in GCTB, and thereby aid in finding the best timing for surgery.
三名下肢患有骨巨细胞瘤（GCTB）的患者，其唯一的手术治疗选择是截肢或严重削弱骨骼，接受了地诺单抗（D-mab）治疗以增强肿瘤部位的骨量。为了量化D-mab治疗期间GCTB病变处骨矿物质密度（BMD）的变化，我们进行了多次双能X线吸收测定（DXA）扫描。这三名患者分别在接受D-mab治疗3、4和8个月后接受了手术。所有三名患者的肿瘤对D-mab均有明显反应，观察到BMD增加高达50%。同一患者髋部和脊柱的对照扫描中BMD几乎没有变化。DXA扫描无法提供有关局部肿瘤反应的信息，但可能有助于评估GCTB中D-mab反应的时间和大小，从而有助于确定最佳手术时机。
