Journal article
The effect of denosumab on pain and radiological improvement in giant cell tumours of the spine in the acute setting
- Abstract:
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Study Design
Retrospective Cohort Study.
Objectives
The current recommended treatment for Giant Cell Tumour (GCT) of the spine is en bloc excision. Denosumab is a monoclonal antibody reducing osteoclast activity that shows promising results when used as a neo – adjuvant treatment. However, the current literature remains limited. The purpose of this study was to assess the effect of denosumab on tumour characteristics and symptom relief in the acute phase of treatment of spinal GCT.
Methods
We performed a retrospective review of 16 patients treated with denosumab as neo-adjuvant and stand - alone treatment. MRI and PET tumour characteristics were taken before and after treatment and patients were interviewed for subjective pain responses.
Results
Following treatment, all patients showed improvement of pain, of which 68.7% of patients were pain free with 43.75% noting improvement within 48 hours. Mean relative volumetric reduction in tumour volume was 37.3% (P < .001). Eight patients showed high grade of Bilsky classification (Epidural spinal cord compression scale - ESCC) with seven of them showing significant improvement to low grade of ESCC (P = .016). Median baseline PET Standardised Uptake Value (SUV)max was 14.57 and post treatment was 4.8 (P < .001).
Conclusions
This study provides necessary insight to the limited literature on the use of denosumab for spinal GCT in the acute phase. The clinical and radiographic responses observed demonstrate the critical role that neo-adjuvant denosumab has by reducing the tumour burden around critical adjacent neurovascular structures before eventual resection, significant pain improvement even with presence of fractured vertebra.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 682.4KB, Terms of use)
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- Publisher copy:
- 10.1177/21925682251314378
Authors
- Publisher:
- SAGE Publications
- Journal:
- Global Spine Journal More from this journal
- Volume:
- 15
- Issue:
- 6
- Pages:
- 2882-2889
- Publication date:
- 2025-01-09
- DOI:
- EISSN:
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2192-5690
- ISSN:
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2192-5682
- Language:
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English
- Keywords:
- Pubs id:
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2077122
- Local pid:
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pubs:2077122
- Deposit date:
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2025-01-10
Terms of use
- Copyright holder:
- Beresford-Cleary et al
- Copyright date:
- 2025
- Rights statement:
- © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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