Zoledronic acid-loaded bone cement as a local adjuvant therapy for giant cell tumor of the sacrum after intralesional curettage.
OBJECTIVE
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 cm(3). 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.
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No 201, Sec 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Kun-Hui
KH
Chen
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No 201, Sec 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Po-Kuei
PK
Wu
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No 201, Sec 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Cheng-Fong
CF
Chen
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No 201, Sec 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC. wmchen@vghtpe.gov.tw.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. wmchen@vghtpe.gov.tw.
Wei-Ming
WM
Chen
D000293:Adolescent; D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003475:Curettage; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000628:therapy*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D011128:Polyradiculopathy / Q000601:surgery*; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D055815:Young Adult; D000077211:Zoledronic Acid
D001843:Bone Cements; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
Bone cement; Curettage; Giant cell tumor of bone; Sacrum; Zoledronic acid