Background

The changes in the characteristics of the tumor blood supply of giant cell tumor of bone over time after treatment with denosumab remain unclear. The purpose of this study was to evaluate the change in the blood supply imaging characteristics of giant cell tumor of bone after preoperative denosumab treatment and to provide evidence for evaluating the reasonable time for preoperative treatment.

Methods

A total of 59 patients with giant cell tumor of bone who were treated in our hospital from 2014 to 2019 were enrolled in the study. All patients underwent enhanced CT examination of the tumor site before denosumab treatment and every month after treatment. The plain CT value and enhanced CT value of the tumor were measured, and the CT enhancement rate of the tumor was calculated. The change in the CT enhancement rate of the tumor over time after denosumab treatment was analyzed.

Results

The average tumor enhancement rates were 2.14 (1.22–4.05), 1.60 (1.12–2.53), 1.38 (1.02–2.24), and 1.25 (1–2.11) before denosumab treatment and one month, three months, and six months after treatment, respectively. After denosumab treatment, the average monthly CT enhancement rate decreased as follows: 0.54 (25.2%) in the first month, 0.11 (5.15%) in the second to third months, and 0.04 (1.87%) in the fourth to sixth months. The tumor enhancement rate was no longer significantly reduced three months post-treatment. There was a significant correlation between the reduction in the CT enhancement rate and the initial CT enhancement rate (P = 0.000).

Conclusion

The preoperative application of denosumab can reduce tumor blood supply. The decrease in the blood supply is the most significant in the initial stage of treatment. Following treatment, the decrease in the blood supply gradually reduces over time. Therefore, for the purpose of reducing intra-operative bleeding and facilitating surgery, application of denosumab treatment is not recommended more than three months before surgery.

中文翻译：

---

地诺单抗治疗骨巨细胞瘤术前影像学改变的研究

背景

地诺单抗治疗后骨巨细胞瘤肿瘤血供特征随时间的变化尚不清楚。本研究旨在评估术前地诺单抗治疗后骨巨细胞瘤血供影像学特征的变化，为评估术前治疗的合理时机提供依据。

方法

2014-2019年在我院收治的骨巨细胞瘤患者共59例入组。所有患者在狄诺塞麦治疗前和治疗后每个月对肿瘤部位进行增强CT检查。测量肿瘤的平扫CT值和增强CT值，计算肿瘤CT增强率。分析了狄诺塞麦治疗后肿瘤CT增强率随时间的变化。

结果

狄诺塞麦治疗前和治疗后1个月、3个月和6个月的平均肿瘤增强率分别为2.14（1.22-4.05）、1.60（1.12-2.53）、1.38（1.02-2.24）和1.25（1-2.11），分别。地诺单抗治疗后，平均每月CT增强率下降如下：第一个月为0.54（25.2%），第二至第三个月为0.11（5.15%），第四至六个月为​​0.04（1.87%）。治疗三个月后肿瘤增强率不再显着降低。CT增强率的降低与初始CT增强率之间存在显着相关性（P = 0.000）。

结论

术前应用狄诺塞麦可减少肿瘤血供。血液供应的减少在治疗的初始阶段最为显着。治疗后，血液供应的减少会随着时间的推移逐渐减少。因此，为减少术中出血和方便手术，不建议术前三个月以上应用地诺单抗治疗。