ABSTRACT
BACKGROUND: Giant cell tumor of bone (GCTB) is a locally aggressive neoplasm with a high propensity for recurrence following intralesional curettage. The introduction of denosumab, a RANKL inhibitor, has shown potential in facilitating joint-sparing surgery. However, concerns exist regarding its impact on local recurrence rates. This study aimed to evaluate the efficacy and safety of combined preoperative denosumab with adjuvant microwave ablation (MWA) for the treatment of high-risk GCTB. METHODS: We conducted a retrospective review of 19 patients with high-risk GCTB who underwent preoperative denosumab treatment followed by curettage and adjuvant MWA. The primary outcome measure was the local recurrence rate, with secondary outcomes including functional status assessed by the Musculoskeletal Tumor Society (MSTS) score and safety profile of the treatment. RESULTS: In this retrospective analysis, we evaluated the outcomes of 19 patients with high-risk GCTB treated with preoperative denosumab and adjuvant MWA. The median follow-up duration was 33.1 months, 3 patients (15.8%) experienced local recurrence at a median of 21.6 months postoperatively and the local recurrence-free survival was 81.2% at two years. Notably, no patient developed lung metastasis, and all recurrences were successfully managed with repeat curettage and MWA, with a mean MSTS score of 27.3. No patient required joint replacement due to tumor recurrence, resulting in a 100% joint preservation rate. CONCLUSION: The combination of preoperative denosumab and adjuvant MWA is a feasible and effective strategy for the management of high-risk GCTB, providing effective local control with preserved joint function. This approach may offer a surgical alternative for young patients where joint preservation is paramount.
Subject(s)
Bone Neoplasms , Denosumab , Giant Cell Tumor of Bone , Microwaves , Humans , Denosumab/therapeutic use , Retrospective Studies , Female , Male , Adult , Microwaves/therapeutic use , Giant Cell Tumor of Bone/surgery , Giant Cell Tumor of Bone/drug therapy , Bone Neoplasms/surgery , Bone Neoplasms/drug therapy , Middle Aged , Young Adult , Treatment Outcome , Combined Modality Therapy , Neoplasm Recurrence, Local , Adolescent , Bone Density Conservation Agents/therapeutic use , Follow-Up Studies , Curettage/methods , Preoperative Care/methodsABSTRACT
The photo-oxidation of Sb(III) to Sb(V) by marine microalgae (diatom, green and red algae) with or without the presence of transition metals (Fe(III), Cu(II) and Mn(II)). The influence of marine phytoplankton on the photochemistry of antimony was confirmed for the first time. The conversion ratio of Sb(III) to Sb(V) increased with increasing algae concentration and irradiation time. Different species of marine phytoplankton were found to have different photo-oxidizing abilities. The photochemical redox of transition metals could induce the species transformation of antimony. After photo-induced oxidation by marine phytoplankton and transition metals, the ratio of Sb(V) to Sb(III) was in the range of 1.07-5.48 for six algae (Tetraselmis levis, Chlorella autotrophica, Nannochloropsis sp., Tetraselmis subcordiformis, Phaeodactylum tricornutum, and Porphyridium purpureum), and only 0.92 for Dunaliella salina. The distribution of antimony in the sunlit surface seawater was greatly affected by combined effects of marine phytoplankton (main contributor) and transition metals; both synergistic and antagonistic effects were observed. The results provided further insights into the distribution of Sb(III) and Sb(V) and the biogeochemical cycle of antimony, and have significant implications for the risk assessment of antimony in the sunlit surface seawater.