Massachusetts General Hospital : Skeletal Biology Research Center
HomeAbout SBRCResearch AgendaSBRC AdministrationAdditional Resources |
Giant Cell Tumors of the Jaw
Although benign, giant cell tumors of the jaw can be aggressive, locally destructive, and disfiguring. Traditionally, patients with giant cell tumors faced resection of the jaw, including removal of surrounding bone and nerves, followed by reconstructive surgery. The SBRC has developed an alternate treatment for patients with these tumors that involves a single, less radical procedure followed by chemotherapy. First reported in Pediatrics in 1999, our group has had remarkable success treating giant cell tumors with less invasive enucleation of the tumor followed by postoperative antiangiogenic therapy using interferon. This is in contrast to en bloc resection and reconstruction with a bone graft. With an enrollment of over 40 subjects in this protocol, the recurrence rate is 5% compared to an historic recurrence rate of 30-60% for these tumors. When the tumor recurs, it can be retreated with interferon or a combination of interferon and a bisphosphonate. Future studies will include the use of antiangiogenic therapy with no operation. The antiangiogenic properties of interferon appear to cripple the highly vascular lesion and to prevent recurrence by impeding revascularization of the area. In addition, the metabolic influence of interferon appears to promote formation of new bone and inhibit resorption of bone at the site of the lesion, eliminating the need for further reconstruction. The SBRC—in collaboration with the OMS Department’s CACI—continues to enroll patients, to study the long-term outcomes of those treated, to identify bio-markers associated with clinical behavior, and to compare and contrast the characteristics and genetic signatures of maxillofacial giant cell tumors with giant cell tumors of long bones. For patient or physician inquiries about this novel protocol or enrolling in our study, contact us at 617.726.2740. BibliographyDewsnup NC, Susarla SM, Abulikemu M, Faquin WC, Kaban LB, August M. Immunohistochemical evaluation of giant cell tumors of the jaws using CD34 density analysis. J Oral Maxillfac Surg 2008;66(5):928-33. Kaban LB, Troulis MJ, Wilkinson MS, Wilkinson MJ, Ebb D, Dodson TB. Adjuvant antiangiogenic therapy for giant cell tumors of the jaws. J Oral Maxillfac Surg 2007;65(10):2018-24. Kaban LB, Troulis MJ, Ebb D, August M, Hornicek FJ, Dodson TB. Antiangiogenic therapy with interferon alpha for giant cell lesions of the jaws. J Oral Maxillofac Surg 2002;60(10):1103-11. Kaban LB, Mulliken JB, Ezekowitz RA, Ebb D, Smith PS, Folkman J. Antiangiogenic therapy of a recurrent giant cell tumor of the mandible with interferon alfa-2a. Pediatrics 1999;103(6 pt 1):1145-9. |
“One of the greatest gifts from our research is the opportunity to offer the patient a lesser surgery with a greater outcome. ” Contact Us: Skeletal Biology |