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Published in: European Spine Journal 10/2015

01-10-2015 | Original Article

Zoledronic acid-loaded bone cement as a local adjuvant therapy for giant cell tumor of the sacrum after intralesional curettage

Authors: Kun-Hui Chen, Po-Kuei Wu, Cheng-Fong Chen, Wei-Ming Chen

Published in: European Spine Journal | Issue 10/2015

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Abstract

Purpose

Giant cell tumor of the sacrum is usually silent in initial stages and not diagnosed until achieving a large size. Intralesional curettage of the tumor has lower risk of neurological damage but is with high recurrence rate. Zoledronic acid-loaded cement was demonstrated to have cytotoxic effect on the cell line of giant cell tumor. This study evaluate if zoledronic acid-loaded bone cement would reduce the recurrence rate of sacral giant cell tumor after intralesional curettage.

Methods

Four patients were diagnosed as sacral giant cell tumor and received intralesional curettage with placement of zoledronic acid-loaded bone cement for adjuvant local control. The clinical records including tumor location, tumor size, complication, follow-up status, and functional outcome were analyzed retrospectively.

Results

All four patients presented with cauda equina syndrome before surgery with mean tumor volume of 472.8 cm3. With placement of zoledronic acid-loaded cement, no local recurrence was observed during the mean follow-up period of 28 months. All patients were found to have new bone regeneration on radiograph. All patients suffering from cauda equina syndrome were recovered.

Conclusions

We suggested that placement of zoledronic acid-loaded bone cement was an effective adjuvant therapy for sacral giant cell tumor following intralesional curettage.
Literature
1.
go back to reference Szendroi M (2004) Giant-cell tumour of bone. J Bone Jt Surg Br 86(1):5–12 Szendroi M (2004) Giant-cell tumour of bone. J Bone Jt Surg Br 86(1):5–12
2.
go back to reference Martin C, McCarthy EF (2010) Giant cell tumor of the sacrum and spine: series of 23 cases and a review of the literature. Iowa Orthop J 30:69–75PubMedCentralPubMed Martin C, McCarthy EF (2010) Giant cell tumor of the sacrum and spine: series of 23 cases and a review of the literature. Iowa Orthop J 30:69–75PubMedCentralPubMed
4.
go back to reference Leggon RE, Zlotecki R, Reith J, Scarborough MT (2004) Giant cell tumor of the pelvis and sacrum: 17 cases and analysis of the literature. Clin Orthop Relat Res 423:196–207CrossRefPubMed Leggon RE, Zlotecki R, Reith J, Scarborough MT (2004) Giant cell tumor of the pelvis and sacrum: 17 cases and analysis of the literature. Clin Orthop Relat Res 423:196–207CrossRefPubMed
5.
go back to reference Marcove RC, Sheth DS, Brien EW, Huvos AG, Healey JH (1994) Conservative surgery for giant cell tumors of the sacrum. The role of cryosurgery as a supplement to curettage and partial excision. Cancer 74(4):1253–1260CrossRefPubMed Marcove RC, Sheth DS, Brien EW, Huvos AG, Healey JH (1994) Conservative surgery for giant cell tumors of the sacrum. The role of cryosurgery as a supplement to curettage and partial excision. Cancer 74(4):1253–1260CrossRefPubMed
6.
go back to reference Althausen PL, Schneider PD, Bold RJ, Gupta MC, Goodnight JE Jr, Khatri VP (2002) Multimodality management of a giant cell tumor arising in the proximal sacrum: case report. Spine 27(15):E361–E365CrossRefPubMed Althausen PL, Schneider PD, Bold RJ, Gupta MC, Goodnight JE Jr, Khatri VP (2002) Multimodality management of a giant cell tumor arising in the proximal sacrum: case report. Spine 27(15):E361–E365CrossRefPubMed
13.
go back to reference Zwolak P, Manivel JC, Jasinski P, Kirstein MN, Dudek AZ, Fisher J, Cheng EY (2010) Cytotoxic effect of zoledronic acid-loaded bone cement on giant cell tumor, multiple myeloma, and renal cell carcinoma cell lines. J Bone Jt Surg Am 92(1):162–168. doi:10.2106/JBJS.H.01679 CrossRef Zwolak P, Manivel JC, Jasinski P, Kirstein MN, Dudek AZ, Fisher J, Cheng EY (2010) Cytotoxic effect of zoledronic acid-loaded bone cement on giant cell tumor, multiple myeloma, and renal cell carcinoma cell lines. J Bone Jt Surg Am 92(1):162–168. doi:10.​2106/​JBJS.​H.​01679 CrossRef
14.
go back to reference Wuisman P, Lieshout O, Sugihara S, van Dijk M (2000) Total sacrectomy and reconstruction: oncologic and functional outcome. Clin Orthop Relat Res 381:192–203CrossRefPubMed Wuisman P, Lieshout O, Sugihara S, van Dijk M (2000) Total sacrectomy and reconstruction: oncologic and functional outcome. Clin Orthop Relat Res 381:192–203CrossRefPubMed
17.
go back to reference Hughes DE, Wright KR, Uy HL, Sasaki A, Yoneda T, Roodman GD, Mundy GR, Boyce BF (1995) Bisphosphonates promote apoptosis in murine osteoclasts in vitro and in vivo. J Bone Miner Res Off J Am Soc Bone Miner Res 10(10):1478–1487. doi:10.1002/jbmr.5650101008 CrossRef Hughes DE, Wright KR, Uy HL, Sasaki A, Yoneda T, Roodman GD, Mundy GR, Boyce BF (1995) Bisphosphonates promote apoptosis in murine osteoclasts in vitro and in vivo. J Bone Miner Res Off J Am Soc Bone Miner Res 10(10):1478–1487. doi:10.​1002/​jbmr.​5650101008 CrossRef
20.
go back to reference Marks KE, Nelson CL, Lautenschlager EP (1976) Antibiotic-impregnated acrylic bone cement. J Bone Jt Surg Am 58(3):358–364 Marks KE, Nelson CL, Lautenschlager EP (1976) Antibiotic-impregnated acrylic bone cement. J Bone Jt Surg Am 58(3):358–364
21.
22.
go back to reference Kivioja AH, Blomqvist C, Hietaniemi K, Trovik C, Walloe A, Bauer HC, Jorgensen PH, Bergh P, Folleras G (2008) Cement is recommended in intralesional surgery of giant cell tumors: a Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years. Acta Orthop 79(1):86–93. doi:10.1080/17453670710014815 CrossRefPubMed Kivioja AH, Blomqvist C, Hietaniemi K, Trovik C, Walloe A, Bauer HC, Jorgensen PH, Bergh P, Folleras G (2008) Cement is recommended in intralesional surgery of giant cell tumors: a Scandinavian Sarcoma Group study of 294 patients followed for a median time of 5 years. Acta Orthop 79(1):86–93. doi:10.​1080/​1745367071001481​5 CrossRefPubMed
24.
go back to reference Arpornchayanon O, Leerapun T (2008) Effectiveness of intravenous bisphosphonate in treatment of giant cell tumor: a case report and review of the literature. J Med Assoc Thail Chotmaihet Thangphaet 91(10):1609–1612 Arpornchayanon O, Leerapun T (2008) Effectiveness of intravenous bisphosphonate in treatment of giant cell tumor: a case report and review of the literature. J Med Assoc Thail Chotmaihet Thangphaet 91(10):1609–1612
25.
Metadata
Title
Zoledronic acid-loaded bone cement as a local adjuvant therapy for giant cell tumor of the sacrum after intralesional curettage
Authors
Kun-Hui Chen
Po-Kuei Wu
Cheng-Fong Chen
Wei-Ming Chen
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-3978-y

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