Предварительные результаты комбинированного лечения гигантоклеточной опухоли кости

Until now, surgical treatment was the method of choice in treating a giant cell tumor, but with the deepening knowledge of the developmental pathogenesis and molecular genetic features of a giant cell tumor, the use of an inhibitory monoclonal antibody, denosumab, in its treatment has been proposed. Goals Simplify the operation by reducing the size of the tumor, fusion of pathological fractures, restoring the function of adjacent joints, sclerosis and pathomorphosis of tumor tissue by conducting 2 courses of denosumab as a neoadjuvant targeted therapy for patients with giant cell bone tumors. Methods Considering the data on the efficacy of denosumab, all patients underwent 2 courses of Denosumab 120 mg subcutaneously 1 time per month, as a neoadjuvant targeted therapy for a giant cell bone before performing a surgical treatment. A comparison was made of the morphological picture before and after the start of treatment, and the clinical and radiological results were evaluated. Results. This method was used to treat 10 patients with giant cell tumors of bones of various sites. I) Clinical effect: all patients showed pain relief and partial restoration of support ability. II) X-ray: hardening of foci of lytic destruction, signs of consolidation of pathological fractures. III) Macroscopically: the consolidation of pathological fractures; on the cut, the pathological foci are filled with dense whitish tissue. IV) Histologically, fibrous tissue and focal hemorrhages were determined between the bone beams. Pronounced therapeutic pathomorphosis of the tumor. Conclusions Denosumab in neoadjuvant targeted therapy for patients with giant cell bone tumors prior to surgical treatment reduces tumor sizes and facilitates fusion of pathological fractures. Denosumab restores functions of adjacent joints, improves the quality of life of patients and provokes sclerosis and pathomorphism of tumor tissues facilitating surgical treatment.