Shi Mingmin, Chen Lei, Wang Yangxin, Wang Wei, Zhang Yujie, Yan Shigui
Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China,
Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Cancer Manag Res. 2019 Jan 11;11:669-680. doi: 10.2147/CMAR.S187316. eCollection 2019.
Giant cell tumor of bone (GCTB) is a locally aggressive tumor, and its postoperative recurrence remains a problem. The present meta-analysis aimed to analyze the effect of bisphosphonates (BPs) on local recurrence of GCTB.
Seven case-control studies were included by computerized searches of bibliographic databases (PubMed, AMED, EMBASE, the Cochrane library, ISI Web of Science, and China National Knowledge Infrastructure). The pooled adjusted ORs were calculated to evaluate the local recurrence of GCTB.
The BP group presented significantly lower total local recurrence rate than the control group in GCTB (<0.01). Subgroup analysis shows BP group presented significantly lower local recurrence than the control group in GCTB with different tumor grades (<0.05). In patients who underwent intralesional curettage, a significantly lower local recurrence rate was found in the BP group compared with the control group (<0.01), but no significance was found for patients who underwent wide resection (=0.16). None of the included studies described severe adverse effects related to BPs.
The results confirmed the effect of BPs on reducing the local recurrence of GCTB, and the effect is not influenced by the tumor grades. BPs are benefit for the patients who underwent intralesional curettage but not recommended for those who underwent wide resection.
骨巨细胞瘤(GCTB)是一种具有局部侵袭性的肿瘤,其术后复发仍是一个问题。本荟萃分析旨在分析双膦酸盐(BPs)对GCTB局部复发的影响。
通过对文献数据库(PubMed、AMED、EMBASE、Cochrane图书馆、ISI科学网和中国知网)进行计算机检索,纳入七项病例对照研究。计算合并调整后的比值比(OR)以评估GCTB的局部复发情况。
在GCTB中,BP组的总局部复发率显著低于对照组(<0.01)。亚组分析显示,在不同肿瘤分级的GCTB中,BP组的局部复发率显著低于对照组(<0.05)。在接受病灶内刮除术的患者中,BP组的局部复发率显著低于对照组(<0.01),但在接受广泛切除术的患者中未发现显著差异(=0.16)。纳入的研究均未描述与BPs相关的严重不良反应。
结果证实了BPs对降低GCTB局部复发的作用,且该作用不受肿瘤分级的影响。BPs对接受病灶内刮除术的患者有益,但不推荐用于接受广泛切除术的患者。