Bhatia Sumita, Miszczyk Leszek, Roelandts Martine, Nguyen Tan Dat, Boterberg Tom, Poortmans Phillip, Vallow Laura, Dincbas Fazilet O, Lassen-Ramshad Yasmin, Botros Maikel, Miller Robert C
Mayo Clinic, Rochester, MN, USA.
Rare Tumors. 2011 Oct 21;3(4):e48. doi: 10.4081/rt.2011.e48. Epub 2011 Dec 16.
The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB) has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow-up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity.
放射治疗在局部控制边缘切除、无法切除及复发性骨巨细胞瘤（GCToB）方面的作用尚未明确界定。受这种罕见疾病影响的患者数量较少。我们报告了一系列58例经活检证实为GCToB且接受放射治疗的患者。在罕见癌症网络的参与机构中，对放射治疗在GCToB治疗中的作用进行了回顾性研究。纳入标准包括对边缘切除、无法切除及复发性GCToB使用放射治疗。对来自9个北美和欧洲参与机构的58例经活检证实为GCToB的患者进行了分析。45例患者为原发性肿瘤，13例患者为复发性肿瘤。中位放射剂量为50 Gy，分25次给予，中位疗程。放射治疗的指征为33例患者边缘切除，13例患者无法切除肿瘤，9例患者复发，2例患者姑息治疗。中位肿瘤大小为7.0 cm。相当一部分肿瘤累及关键结构。中位随访时间为8.0年。5年局部控制率为85%。在7例局部复发患者中，3例通过挽救性手术成功治疗。所有接受姑息治疗的患者症状均得到缓解。5年总生存率为94%。所有患者均未出现3级或更高级别的急性毒性反应。本研究报告了放射治疗GCToB的大量已发表经验。放射治疗可为不完全切除、无法切除或复发性GCToB提供良好的局部控制，且发病率可接受。
