Szostakowski Bartłomiej, Morysiński Tadeusz, Rutkowski Piotr, Spałek Mateusz Jacek
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Department of Radiotherapy 1, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Rep Pract Oncol Radiother. 2024 Oct 3;29(4):437-444. doi: 10.5603/rpor.101993. eCollection 2024.
Osteoblastoma (OB) is a rare benign bone tumor, mainly affecting adolescents and young adults. It's commonly found in the spine and long bones, with a male-to-female ratio of 2:1. Surgery, primarily en bloc resection or curettage, is the main treatment. Radiotherapy (RT) or systemic treatment is considered in specific cases. However, optimal RT strategies remain unclear due to limited and outdated data. This study aims to evaluate RT role, efficacy, and safety in treating OB.
The study group was a cohort of consecutive patients with OB treated in our institute that received RT in years 1998-2023. We analyzed indication for RT, irradiated site, RT technique, total dose, dose per fraction, early and late tolerance, and survival.
Thirteen patients meeting the criteria were analyzed. Most were males (10 out of 13) with a median age of 21. Most OBs were within the vertebral column. All patients received definitive RT for unresectable disease and underwent conventionally fractionated RT (1.8-2.0 Gy per fraction) to total doses 40-70.2 Gy. Only mild acute toxicity was observed. No late toxicity was reported. The median follow-up was 118 months. Local progression was observed in four patients, all of whom died.
RT is a valuable option for certain OB patients ineligible for surgery. Seeking treatment at specialized bone tumor centers with RT techniques is crucial due to OB's rarity and the lack of standardized guidelines. Recommended RT doses fall between 50-70 Gy using intensity-modulated techniques in conventional 1.8-2 Gy fractions.
骨母细胞瘤（OB）是一种罕见的良性骨肿瘤，主要影响青少年和青年。它常见于脊柱和长骨，男女比例为2:1。手术，主要是整块切除或刮除术，是主要的治疗方法。在特定情况下考虑放疗（RT）或全身治疗。然而，由于数据有限且过时，最佳放疗策略仍不明确。本研究旨在评估放疗在治疗骨母细胞瘤中的作用、疗效和安全性。
研究组为1998年至2023年在我院接受放疗的连续骨母细胞瘤患者队列。我们分析了放疗指征、照射部位、放疗技术、总剂量、每次分割剂量、早期和晚期耐受性以及生存率。
分析了13例符合标准的患者。大多数为男性（13例中的10例），中位年龄为21岁。大多数骨母细胞瘤位于脊柱内。所有患者均因不可切除的疾病接受了根治性放疗，并接受了常规分割放疗（每次分割1.8 - 2.0 Gy），总剂量为40 - 70.2 Gy。仅观察到轻度急性毒性。未报告晚期毒性。中位随访时间为118个月。4例患者出现局部进展，均死亡。
放疗是某些不适合手术的骨母细胞瘤患者的一种有价值的选择。由于骨母细胞瘤罕见且缺乏标准化指南，在具有放疗技术的专业骨肿瘤中心寻求治疗至关重要。推荐使用调强技术，以常规1.8 - 2 Gy分割给予50 - 70 Gy的放疗剂量。
