Objective  To investigate the relapse rate, functional recovery and safety of extended curettage combined with denosumab as adjuvant therapy in patients with giant cell  tumor of the bone, thereby providing guidance for clinical management.

Methods  A retrospective analysis was conducted on data from 56 patients with giant cell tumor of the bone who were admitted to Liuzhou Worker's Hospital between January 2018 and October 2024 and were divided into a study group and a control group, each comprising 28 patients. Patients in the control group under went extended curettage combined with standard perioperative management; the study group received the same treatment as the control group but with the addition of a denosumab adjuvant therapy regimen. The two groups were compared in terms of Enneking limb function scores, imaging findings, postoperative relapse rate, pain relief and limb function recovery(VAS pain score, MSTS functional score), bone metabolism markers (RANK, RANKL, OPG), and the incidence of skeletal-related events and adverse reactions.

Results  In the study group, the proportion of patients achieving an excellent or good Enneking limb function score (92.86% vs. 71.43%), MSTS functional score (25.32±3.09 vs. 20.15±3.26) and OPG levels (316.64±25.52 vs. 273.87±26.45) were significantly higher in the study group than in the control group (P<0.05), RANK (6.16±1.05 vs. 7.24±1.24), RANKL (9.37±2.15 vs.13.16±2.23), VAS pain scores (2.96±1.17 vs. 3.72±1.24), and the incidence of adverse events (10.71% vs. 53.57%) were all lower than in the control group (P<0.05); however, there was no statistically significant difference between the two groups in postoperative relapse rate or the incidence of adverse bone events; radiological assessment showed that the study group demonstrated superior outcomes to the control group in terms of the reduction in maximum tumor longitudinal diameter, maximum soft tissue mass diameter, and post-contrast tumor parenchymal CT value, as well as the increase in the thinnest cortical bone thickness and the distance from the articular surface (P<0.05).

Conclusion  Extended curettage combined with adjuvant denosumab therapy for giant cell tumor of the bone of the extremities can effectively improve bone metabolic levels, alleviate pain, enhance limb function, and reduce the relapse rate and incidence of adverse reactions. Furthermore, as it is minimally invasive and allows for rapid recovery, it provides a basis for the clinical management of giant cell tumor of the bone.

1. 张建斌, 吕智. 骨巨细胞瘤治疗研究进展[J]. 实用骨科杂志, 2024, 30(6): 519-523. [Zhang JB, Lyu Z. Advances in the treatment of osteoblastoma[J]. Journal of Practical Orthopaedics, 2024, 30(6): 519-523.] DOI: 10.13795/j.cnki.sgkz.2024.06.002.

2. 孙梓威, 吴哲宇, 张罗晟, 等. 地舒单抗在骨巨细胞瘤新辅助治疗中的应用研究进展[J]. 脊柱外科杂志, 2023, 21(3): 196-202. [Sun ZW, Wu ZY, Zhang LS, et al. Research progress on application of denosumab in neoadjuvant therapy for giant cell tumor of bone[J]. Journal of Spinal Surgery, 2023, 21(3): 196-202.] DOI: 10.3969/j.issn.1672-2957.2023.03.010.

3. 么文淏, 范道洋, 蒋协远, 等. 四肢骨巨细胞瘤合并病理性骨折的治疗进展[J]. 中华外科杂志, 2025, 63(1): 81-85. [Yao WH, Fan DY, Jiang XY, et al. Progress in the treatment of giant cell tumors of extremities with pathological fracture[J]. Chinese Journal of Surgery, 2025, 63(1): 81-85.] DOI: 10.3760/cma.j.cn112139-20240328-00151.

4. 林育林, 张余. 骨巨细胞瘤及其辅助治疗研究现状[J]. 中国骨科临床与基础研究杂志, 2016, 8(2): 112-119. [Lin YL, Zhang Y. Current researches for giant cell tumor of bone and its adjuvant therapy[J]. Chinese Journal of Clinical and Basic Orthopaedic Research, 2016, 8(2): 112-119.] DOI: 10.3969/j.issn.1674-666X.2016.02.009.

5. 陈永刚. 囊内刮除术与囊外切除术治疗股骨骨巨细胞瘤的效果比较分析[J]. 中国实用乡村医生杂志, 2022, 29(1): 68-71. [Chen YG. Comparative analysis of intracapsular curettage and extracapsular resection in the treatment of  giant cell tumor of femur[J]. Chinese Practical Journal of Rural Doctor, 2022, 29(1): 68-71.] DOI: 10.3969/j.issn.1672-7185.2022.01.024.

6. 王寒, 肖砚斌, 张漾杰, 等. 地舒单抗联合手术治疗多中心骨巨细胞瘤一例[J].骨科临床与研究杂志, 2024, 9(2): 91-93. [Wang H, Xiao YB, Zhang YJ, et al. A case of multicentric giant cell tumour of bone treated with denosumab combined with surgery[J]. Journal of Clinical Orthopedics and Research, 2024, 9(2): 91-93.] DOI: 10.19548/j.2096-269x.2024.02.006.

7. Campanacci M, Baldini N, Boriani S, et al. Giant-cell tumor of bone[J]. J Bone Joint Surg Am, 1987, 69(1): 106-114. https://pubmed.ncbi.nlm.nih.gov/3805057/

8. 洪海森, 洪加源, 沙漠, 等. 锁骨骨肿瘤切除后骨缺损的修复重建研究[J]. 中国骨与关节损伤杂志, 2022, 37(5): 532-534. [Hong HS, Hong JY, Sha M, et al. A study on the repair and reconstruction of bone defects following surgical resection of clavicular tumours[J]. Chinese Journal of Bone and Joint Injury, 2022, 37(5): 532-534.] DOI: 10.7531/j.issn.1672-9935.2022.05.026.

9. 陈粲一, 蔡善保, 方策, 等. “三明治”技术治疗膝关节骨巨细胞瘤疗效分析[J].安徽医学, 2021, 42(5): 473-476. [Chen CY, Cai SB, Fang C, et al. Analysis of effect of sandwich technique in treatment of giant cell tumor of bone of knee joint[J]. Anhui Medical Journal, 2021, 42(5): 473-476.] DOI: 10.3969/j.issn.1000-0399.2021.05.001.

10. 甘锋平, 罗翔, 陈国平, 等. 3D打印个性化填充假体治疗膝关节周围骨巨细胞瘤早期疗效[J]. 中国修复重建外科杂志, 2020, 34(6): 751-755. [Gan FP, Luo X, Chen GP, et al. Treatment of giant cell tumor of bone around knee joint with three-dimensional printing personalized prosthesis[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(6): 751-755.] DOI: 10.7507/1002-1892.201909109.

11. 范梦科, 王玲, 马江涛, 等. 骨巨细胞瘤复发转移机制的研究进展[J]. 中华解剖与临床杂志, 2020, 25(2): 208-212. [Fan MK, Wang L, Ma JT, et al. Research progress on the mechanism of recurrence and metastasis of giant cell tumor of bone[J]. Chinese Journal of Anatomy and Clinics, 2020, 25(2): 208-212.] DOI: 10.3760/cma.j.cn101202-20190220-00062.

12. 庞杰, 孙宗丕, 张昊, 等. 肿瘤刮除灭活植骨术联合地舒单抗治疗股骨远端骨巨细胞瘤的疗效分析[J]. 中国临床医生杂志, 2025, 53(7): 888-891. [Pang J, Sun ZP, Zhang H, et al. Efficacy analysis of tumor curettage and inactivation bone grafting combined with denosumab for distal femoral osteoblastoma[J]. Chinese Journal for Clinicians, 2025, 53(7): 888-891.] DOI: 10.3969/j.issn.2095-8552.2025.07.020.

13. Deventer N, Budny T, Gosheger G, et al. Giant cell tumor of bone: a single center study of 115 cases[J]. Bone Oncol. 2022, 33: 100417. DOI: 10.1016/j.jbo.2022.100417.

14. 毕梦娜, 李钟, 杨磊, 等. 钻孔减压结合自体松质骨及同种异体骨植骨治疗股骨头坏死的短期疗效观察[J]. 生物骨科材料与临床研究, 2023, 20(5): 63-68. [Bi MN, Li Z, Yang L, et al. Short-term efficacy of drilling decompression combined with autogenous cancellous bone and allogeneic bone grafting in the treatment of osteonecrosis of the femoral head[J]. Orthopaedic Biomechanics Materials and Clinical Study, 2023, 20(5): 63-68.]DOI: 10.3969/j.issn.1672-5972.2023.05.013.

15. Cheng YY, Huang L, Lee KM, et al. Bisphosphonates induce apoptosis of stromal tumor cells in giant cell tumor of bone[J]. Calcif Tissue Int, 2004, 75(1): 71-77. DOI: 10.1007/s00223-004-0120-2.

16. 王玉琦, 刘文婷, 刘德森, 等. 自体骨联合同种异体骨治疗股骨大转子软骨母细胞瘤合并巨大骨囊肿1例[J]. 局解手术学杂志, 2021, 30(8): 739-741. [Wang YQ, Liu WT, Liu DS, et al. Autogenous bone combined with allogeneic bone in the treatment of chondroblastoma of greater trochanter of femur with giant bone cyst: a case report[J]. Journal of Regional Anatomy and Operative Surgery, 2021, 30(8): 739-741.] DOI: 10.11659/jjssx.03E021120.

17. 曲昊, 李恒元, 黄鑫, 等. 保留假体的序贯疗法治疗骨肿瘤保肢术后假体周围感染[J]. 中华骨科杂志, 2021, 41(7): 427-435. [Qu H, Li HY, Huang X, et al. Prosthesis-preserving sequential method for treatment of peripheral prosthesis infection after bone tumor limb salvage[J]. Chinese Journal of Orthopaedics, 2021, 41(7): 427-435.] DOI: 10.3760/cma.j.cn121113-20210222-00195.

18. 叶招明, 高宏梁, 林秾, 等. 扩大刮除骨水泥填充术在四肢长骨巨细胞瘤的疗效分析[J]. 2014 年浙江省骨科学学术年会论文汇编, 2014. [Ye ZM, Gao HL, Lin N, et al. Analysis of the efficacy of expanded bone cement augmentation in the treatment of giant cell tumours of the long bones of the extremities[J].Proceedings of the 2014 Annual Conference of the Zhejiang Orthopaedic Society, 2014] https://kns.cnki.net/kcms2/article/abstract?v=JITlTmCwHjKTCvue_kFjvMebNdkxIa7Ehj49yG-vd6pIy47hqeeeYatw9CmlpUe6jAPpytzaHryP98IafDNci2w2TbdHUZHGnB2haJqmo6zCSu6IhpikRkoaQOoQOwMGBbwu3HmvFIf-JthVrfuLsUtbxJYe8Qe_6TLiQ6qfL8njfs1WUDx70bvZOn7Eta89&uniplatform=NZKPT&language=CHS

19. 张宁宁, 于露, 李利平, 等. 地舒单抗在骨质疏松症和肿瘤性骨病中的临床应用及挑战综述[J]. 实用临床医药杂志, 2024, 28(11): 144-148. [Zhang NN, Yu L, Li LP, et al. Review in clinical application and challenges of denosumab in osteoporosis and neoplastic bone disease[J]. Journal of Clinical Medicine in Practice, 2024, 28(11): 144-148.] DOI: 10.7619/jcmp.20233157.

20. 李凤兰, 屠重棋, 陈咏梅, 等. 湿性愈合疗法用于胫骨远端骨巨细胞瘤术后复发再手术后创面不愈一例[J].华西医学, 2023, 38(5): 795-797. [Li FL, Tu ZQ, Chen YM, et al. Wet healing therapy for a non-healing wound following revision surgery for recurrent distal tibial osteoblastoma[J].West China Medical Journal, 2023, 38(5): 795-797.] DOI: 10.7507/1002-0179.202111126.

21. 中国老年学与老年医学会骨科学分会, 山东省抗癌协会骨与软组织肿瘤分会, 于秀淳. 核因子κB受体活化因子配体抑制剂治疗骨巨细胞瘤临床应用的专家共识[J]. 中国骨与关节杂志, 2025, 14(2): 170-181. [ Chinese Society of Gerontology and Geriatrics Orthopedic Branch, Shandong Branch of the Anti-Cancer Association for Bone and Soft Tissue Tumors, Yu XC. Consensus on the clinical application of rANKL therapy for giant cell Tumor of Bone[J]. Chinese Journal of Bone and Joint, 2025, 14(2): 170-181.] DOI: 10.3969/j.issn.2095-252X.2025.02.011.

22. Rutkowski P, Ferrari S, Grimer RJ, et al. Surgical downstaging in an open-label phase II trial of denosumab in patients with giant cell tumor of bone[J]. AnnSurg Oncol, 2015, 22(9): 2860-2868. DOI: 10.1245/s10434-015-4634-9.

23. 费翔, 潘珍, 程冬冬, 等. 骨巨细胞瘤治疗研究进展[J]. 国际骨科学杂志, 2024, 45(4): 219-223. [Fei X, Pan Z, Chen DD, et al. Advances in the treatment of osteoblastoma[J]. International Journal of Orthopaedics, 2024, 45(4): 219-223.] DOI: 10.3969/j.issn.1673-7083.2024.04.001.

24. 周宇翔, 沈烈军, 万诗雨, 等. 骨免疫调节特性骨组织工程支架在修复骨缺损中的应用和发展[J]. 中国组织工程研究, 2024, 28(29): 4734-4740. [Zhou XY, Shen LJ, Wan SY, et al. Application and development of bone tissue engineering scaffolds with bone immune regulatory properties in repairing bone defects[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(29): 4734-4740.] DOI: 10.12307/2024.566.

25. 杨勇昆, 黄真, 苏永彬, 等. 骨巨细胞瘤的肿瘤血运变化与地舒单抗用药时间的相关性研究[J]. 临床肿瘤学杂志, 2020, 25(11): 1005-1010. [Yang YK, Huang Z, Su YS, et al. Study on the relationship between the changes of tumor blood supply and the treatment time of denosumab in giant cell tumor of bone[J].Chinese Clinical Oncology, 2020, 25(11): 1005-1010.] DOI: 10.3969/j.issn.1009-0460.2020.11.008.魏懿浩, 曹思旸, 齐天天, 等. 地舒单抗治疗绝经后骨质疏松性骨折的效果及其对骨代谢标志物的影响[J]. 中国老年学杂志, 2024, 44(11): 2628-2631. [Wei YH, Cao SY, Qi TT, et al. Treatment effect of denosumab on postmenopausal osteoporotic fractures and its influence on bone metabolic markers[J].Chinese Journal of Gerontology, 2024, 44(11): 2628-2631.] https://kns.cnki.net/kcms2/article/abstract?v=JITlTmCwHjJRrr0XCL_Gu8XgOSBJzVkzJxvkrXyaVTk1_81lGStcxN_BAvVJTMsdpK5YjUwPwG95eZj84S4dxUooeJnbER7pBbCMYU33VzpxH7CE2lCpiRyAx66mAICJjfzfXbqDktoCjPB5gXQkYWKkkoRPLN7ZD5o1Jz4ZVFxsWg4nTAbiTw==&uniplatform=NZKPT&language=CHS