Efficacy of bisphosphonates as adjuvant therapy in surgically treated giant cell tumours of bone: a randomized comparative study

Akash Singhal; Vicky Kumar; Devarsh Goyal; Raj Kumar Harshwal

doi:10.18203/issn.2455-4510.IntJResOrthop20262024

Authors

Akash Singhal Department of Orthopedics, S.M.S Medical College, Jaipur, Rajasthan, India
Vicky Kumar Department of Orthopedics, S.M.S Medical College, Jaipur, Rajasthan, India
Devarsh Goyal Department of Orthopedics, S.M.S Medical College, Jaipur, Rajasthan, India
Raj Kumar Harshwal Department of Orthopedics, S.M.S Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262024

Keywords:

Giant cell tumour, Bisphosphonate, Alendronate, Recurrence, MSTS score, Adjuvant therapy

Abstract

Background: Giant cell tumor (GCT) of bone is a locally aggressive neoplasm with high recurrence rates following surgical treatment. Bisphosphonates have emerged as potential adjuvant agents that may reduce recurrence by inducing apoptosis in osteoclast-like giant cells and neoplastic stromal cells through inhibition of the RANK/RANKL pathway.

Methods: This prospective randomized double-blind study enrolled 60 patients with histologically confirmed GCT of extremities at SMS Medical College, Jaipur, from January to December 2024. Group A (n=30) received surgery plus oral Alendronate 10 mg daily for 6 months; Group B (n=30) underwent surgery alone. Outcomes were assessed using radiological evaluation (NCCT), VAS for pain, and MSTS functional score at 1, 2, 3, and 6 months.

Results: Recurrence was significantly lower in the bisphosphonate group (03.33% vs 16.67%, p=0.085). At 6 months, Group A showed superior pain relief (VAS 1.70±0.84 vs 2.97±0.89) and functional recovery (MSTS 26.9±1.53 vs 23.4±1.87). Complications were fewer in Group A (06.67% vs 20.00%). Radiological monitoring revealed 96.67% disease-free status in Group A versus 83.33% in Group B.

Conclusions: Adjuvant oral bisphosphonate therapy following surgical treatment of GCT of bone effectively reduces recurrence rates and improves functional outcomes. It represents a safe, affordable, and accessible option for enhancing disease control in GCT management.

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