title: Local administration of zoledronic acid for giant cell tumor of bone.
abstract: Giant cell tumor of bone is a locally aggressive tumor with a high local recurrence rate. Several adjuvant therapies have been employed to reduce the recurrence rate, but their effectiveness remains controversial. The authors attempted local administration of zoledronic acid, a nitrogen-containing bisphosphonate that strongly inhibits bone resorption, as an adjuvant treatment for histologically proven giant cell tumor of bone in 5 patients at their institution. After biopsy, 4 patients were treated with local administration of zoledronic acid with artificial bone and 1 was treated with zoledronic acid without artificial bone. Histologic response to the treatment was evaluated with surgically resected specimens. The 4 patients treated with artificial bone showed local control, with histologic tumor necrosis rates of 90%, 90%, 50%, and 10%. Magnetic resonance imaging showed poor gadolinium enhancement, and histologic examination after local zoledronic acid treatment showed tumor necrosis. One patient without artificial bone showed no histologic tumor necrosis and had local recurrence in soft tissue 18 months after tumor resection. A 3-week waiting period between biopsy and zoledronic acid treatment appears reasonable from the histological study. Complication of this therapy was delayed wound healing and it occurred in 2 cases. Taken together, this case series suggests that local administration of zoledronic acid with artificial bone is a potential adjuvant therapy for giant cell tumor of bone. On the other hand, effective local administration of zoledronic acid requires some bone matrix, including artificial bone. Campanacci's grading is important for predicting the effect of local administration of zoledronic acid.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishisho
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Hanaoka
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyagi
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.forename: Shunichi
authors.initials: S
authors.lastname: Toki
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Endo
authors.initials: E
authors.lastname: Kenji
authors.forename: Natsuo
authors.initials: N
authors.lastname: Yasui
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D018786:Bone Substitutes; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D055815:Young Adult; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D018786:Bone Substitutes; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid