Publication:

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

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.