The Efficacy of Bisphosphonate in the Treatment of Giant Cell Tumour of the Bone: A Systematic Review and MetaAnalysis
https://doi.org/10.5704/MOJ.2303.012
- Author:
Deslivia MF
1
;
Savio SD
1
;
Wiratnaya IGE
1
;
Astawa P
1
;
Sandiwidayat KS
1
;
Bimantara NG
1
Author Information
1. Department of Orthopaedics and Traumatology, Universitas Udayana, Denpasar, Indonesia
- Publication Type:Journal Article
- Keywords:
bisphosphonate, giant cell tumour, meta-analysis
- From:Malaysian Orthopaedic Journal
2023;17(No.1):98-110
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Anti-osteoclastic mechanism of
Bisphosphonate (BP) is crucial to treat Giant Cell Tumour of
the Bone (GCTB), however no established guidelines of its
use have been published. This systematic review and metaanalysis is the first to summarise recent clinical studies on
the subject.
Materials and methods: A systematic search was
performed based on PRISMA guidelines for clinical trials of
BP administration in GCTB. Baseline data including BP
regimen, dose and timing was summarised. The primary
outcomes assessed were recurrence rate, metastases, survival
rate, functional outcome, clinical outcome, radiological
outcome, and adverse effect.
Results: We identified 8 articles from 2008-2020. Most
studies administer 4mg of Zoledronic acid post-operatively,
with five studies mentioning pre-operative administration
and six studies describing post-operative administration.
There was a total of 181 GCTB cases analysed in this study.
The BP group presented lower recurrence rate than control
group (three studies; Odds Ratio [OR] 0.15; 95% Confidence
Interval [CI], 0.05 – 0.43; p<0.05; heterogeneity, I2=0%). As
for survival rate, BP group is comparable to control group
(two studies; OR 1.67; 95% CI, 0.06 – 48.46; p=0.77;
heterogeneity, I2=65%).
Conclusion: Bisphosphonate therapy offers satisfactory
recurrence rate, functional outcome, clinical outcome,
radiological outcome, survival rate and metastases rate in
patients with GCTB, with minimal adverse effects. Pre- and
post-operative administration of bisphosphonates in
combination might be the most beneficial in minimalising
the recurrence rate.
- Full text:16.2023my1299.pdf
