{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:49:21Z","timestamp":1782604161763,"version":"3.54.5"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Giant cell tumors (GCTs) of the spine are rare and complex to treat. They have a propensity for local recurrence and the potential to metastasize. Treatment is currently surgical and presents unique challenges due to the proximity of neural structures and the need for reconstruction. Denosumab has been shown in clinical trials to be an effective treatment for GCT, but has not yet been studied specifically in GCT of the spine or as a surgical adjunct. To the authors' knowledge this is the first such reported series.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A multicenter, prospective series of 5 patients with GCT of the spine treated with denosumab were included. Patient demographic data, oncological history, neurological status, tumor staging, treatment details and adverse events, surgical procedure, complications, radiological and histological responses, and patient outcome were analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>All patients were women, with a mean age of 38 years, and presented with pain; 2 patients had additional neurological signs and symptoms. The mean duration of symptoms was 62 weeks. No patient had a prior tumor or metastatic disease at presentation. All patients had Enneking Stage III tumors and were treated with monthly cycles of 120 mg of denosumab, with initial additional loading doses on Days 8 and 15. Patients were given daily supplements of calcium (500 mg) and vitamin D (400 IU). There were no denosumab-related adverse events. All patients had a radiological response to denosumab. One patient failed to have a histological response to denosumab, with &gt; 90% of tumor cells found to be viable on histological investigation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study reports the early experience of using denosumab in the treatment of spinal GCT. The results demonstrate a clinically beneficial radiological response and an impressive histological response in most but not all patients. Further experience with denosumab and longer patient follow-up is required. Denosumab has the potential to change the treatment paradigm for spinal GCT.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.spine13937","type":"journal-article","created":{"date-parts":[[2015,2,20]],"date-time":"2015-02-20T15:36:13Z","timestamp":1424446573000},"page":"526-533","source":"Crossref","is-referenced-by-count":72,"title":["Giant cell tumors of the spine: has denosumab changed the treatment paradigm?"],"prefix":"10.3171","volume":"22","author":[{"given":"Tony","family":"Goldschlager","sequence":"first","affiliation":[{"name":"Combined Neurosurgical and Orthopaedic Spine Program and"},{"name":"Department of Neurosurgery, Monash Health, and"},{"name":"Department of Surgery and Monash Institute of Medical Research, Monash University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Dea","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopaedic Spine Program and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Boyd","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopaedic Spine Program and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Spinal Unit, Oxford University Trust Hospital, Oxford, United Kingdom;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyaskumar","family":"Patel","sequence":"additional","affiliation":[{"name":"Departments of Oncology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence D.","family":"Rhines","sequence":"additional","affiliation":[{"name":"Neurosurgery, MD Anderson Cancer Center, Houston, Texas;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehud","family":"Mendel","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Department of Pathology, Vancouver General Hospital, Vancouver, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Ramos","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias A.","family":"Mattei","sequence":"additional","affiliation":[{"name":"Oncology, Ohio State University, Columbus, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles G.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopaedic Spine Program and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine13937","series-title":"J Med Assoc Thai","first-page":"1609","article-title":"Effectiveness of intravenous bisphosphonate in treatment of giant cell tumor: a case report and review of the literature","volume":"91","author":"Arpornchayanon","year":"2008"},{"key":"b2-spine13937","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E37","DOI":"10.1097\/BRS.0b013e3182233ccd","article-title":"Giant cell tumor of the mobile spine: a review of 49 cases","volume":"37","author":"Boriani","year":"2012"},{"key":"b3-spine13937","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/s00586-009-1137-z","article-title":"Morbidity of en bloc resections in the spine","volume":"19","author":"Boriani","year":"2010"},{"issue":"22 Suppl","key":"b4-spine13937","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S48","DOI":"10.1097\/BRS.0b013e3181b969ac","article-title":"Challenges of local recurrence and cure in low grade malignant tumors of the spine","volume":"34","author":"Boriani","year":"2009"},{"key":"b5-spine13937","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1097\/00007632-199705010-00020","article-title":"Primary bone tumors of the spine. 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