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Therapeutic radiotherapy for giant cell tumor of the spine: a systemic review

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Abstract

Background

Giant cell tumor of the bone (GCTB) is a benign but locally aggressive tumor. Giant cell tumor of the spine (GCTS) accounts for 3–6 % of GCTB. Surgery remains the treatment of choice. For those not suitable for surgery, therapeutic radiotherapy (RT) is one classic modality. Although there are several articles on therapeutic RT for GCTS therapy, few systemic reviews have been performed on effects of therapeutic RT on GCTS.

Methods and materials

We searched EMBASE and Medline databases for papers reporting therapeutic radiotherapy for GCTS patients not suitable for surgical resection. The inclusion criteria and prognosis indicators have been defined prior to data extraction. Information of the included patients has been discreetly recorded. We analyzed the prognosis of therapeutic RT and multiple data concerning the GCTS patients. The indicators for prognosis were computed by SPSS software. The local control (LC) and overall survival (OS) rate was estimated by the Kaplan–Meier method. p values ≤0.5 were considered statistically significant.

Result

We included 13 studies comprising 42 patients who received therapeutic radiotherapy with doses ranging from 21 to 80 Gy. The results suggested a response rate of 100 %, OS of 97.6 %, 1-year local control rate (LC) of 85.4 %, 2-year LC rate of 80.2 %, and overall LC of 79 %. No patient reported malignant transformation albeit four had post-RT neurological complications. Four had distant metastasis of the tumor. Patients with previously repeated recurrence had worse prognosis after RT (p = 0.028). No association between dosage and prognosis was found.

Conclusion

Therapeutic RT could provide a satisfactory prognosis for GCTS patients according to this study, and can be an alternative treatment modality for GCTS patients not suitable for surgery.

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References

  1. Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, Hardes J, Gosheger G (2008) Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol 134:969–978

    Article  CAS  PubMed  Google Scholar 

  2. Campanacci M, Baldini N, Boriani S, Sudanese A (1987) Giant-cell tumor of bone. J Bone Joint Surg 69:106–114

    CAS  PubMed  Google Scholar 

  3. Freyschmidt J, Ostertag H, Jundt G (1998) Knochentumoren, 2nd edn. Springer, Berlin

    Google Scholar 

  4. Carrasco CH, Murray JA (1989) Giant cell tumors. Orthop Clin N Am 20:395–405

    CAS  Google Scholar 

  5. Salzer-Kuntschik M (1998) Differential diagnosis of giant cell tumor of bone. Verhandlungen der Deutschen Gesellschaft für Pathologie 82:154–159

    CAS  PubMed  Google Scholar 

  6. Suit H, Spiro I (1999) Radiation treatment of benign mesenchymal disease. Semin Radiat Oncol 9:171–178

    Article  CAS  PubMed  Google Scholar 

  7. Sung H, Kuo P, Shu W, Chai Y, Liu C, Li S (1982) Giant-cell tumor of bone: analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg 64-A:755–761

    Google Scholar 

  8. McDonald DJ, Sim FH, McLeod RA, Dahlin DC (1986) Giant-cell tumour of bone. J Bone Joint Surg 68:235–242

    CAS  PubMed  Google Scholar 

  9. Schwimer SR, Bassett LW, Mancuso AA, Mirra JM, Dawson EG (1981) Giant cell tumor of the cervicothoracic spine. Am J Roentgenol 136(1):63–67

    Article  CAS  Google Scholar 

  10. Bell RS, Harwood AR, Goodman SB, Fornasier VL (1983) Supervoltage radiotherapy in the treatment of difficult giant cell tumors of bone. Clin Orthop Relat Res 174:208–216

    PubMed  Google Scholar 

  11. Groof De, Verdonk R, Vercauteren M, Schelstraete K, Roels H, Claessens H (1990) Giant-cell tumor involving a lumbar vertebra: long-term follow-up after radiotherapy. Spine 15(8):835–838

    PubMed  Google Scholar 

  12. Bennett CJ, Marcus RB, Million RR, Enneking WF (1993) Radiation therapy for giant cell tumor of bone. Int J Radiat Oncol Biol Phys 26(2):299–304

    Article  PubMed  Google Scholar 

  13. Malone S, O’Sullivan B, Catton C, Bell R, Fornasier V, Davis A (1995) Long-term follow-up of efficacy and safety of megavoltage radiotherapy in high-risk giant cell tumors of bone. Int J Radiat Oncol Biol Phys 33(3):689–694

    Article  CAS  PubMed  Google Scholar 

  14. Khan DC, Malhotra S, Stevens RE, Steinfeld AD (1999) Radiotherapy for the treatment of giant cell tumor of the spine: a report of six cases and review of the literature. Cancer Invest 17(2):110–113

    Article  CAS  PubMed  Google Scholar 

  15. Chakravarti A, Spiro IJ, Hug EB, Mankin HJ, Efird JT, Suit HD (1999) Megavoltage radiation therapy for axial and inoperable giant-cell tumor of bone. J Bone Joint Surg 81(11):1566–1573

    CAS  PubMed  Google Scholar 

  16. Nair Madhavan Krishnan, Jyothirmayi Rema (1999) Radiation therapy in the treatment of giant cell tumor of bone. Int J Radiat Oncol Biol Phys 43(5):1065–1069

    Article  CAS  PubMed  Google Scholar 

  17. Fujimoto N, Nakagawa K, Seichi A, Terahara A, Tago M, Aoki Y, Hosoi Y, Ohtomo K (2001) A new bisphosphonate treatment option for giant cell tumors. Oncol Rep 8(3):643–647

    CAS  PubMed  Google Scholar 

  18. Caudell JJ, Ballo MT, Zagars GK, Lewis VO, Weber KL, Lin PP, Marco RA, El-Naggar AK, Benjamin RS, Yasko AW (2003) Radiotherapy in the management of giant cell tumor of bone. Int J Radiat Oncol Biol Phys 57(1):158–165

    Article  PubMed  Google Scholar 

  19. Tsuchiya H, Kokubo Y, Sakurada K, Sonoda Y, Saito S, Kayama T (2005) A case of giant cell tumor in atlas. No shinkei geka 33(8):817–823

    PubMed  Google Scholar 

  20. Meyer A, Bastian L, Bruns F (2006) Benign giant cell tumor of the spine: an unusual indication for radiotherapy. Arch Orthop Trauma Surg 126(8):517–521

    Article  CAS  PubMed  Google Scholar 

  21. Balke M, Henrichs MP, Gosheger G, Ahrens H, Streitbuerger A, Koehler M, Bullmann V, Hardes J (2012) Giant cell tumors of the axial skeleton. Sarcoma 2012:410973

    Article  PubMed Central  PubMed  Google Scholar 

  22. Dahlin DC, Cupps RE, Johnson EW (1970) Giant cell tumor: a study of 195 cases. Cancer 25:1061–1070

    Article  CAS  PubMed  Google Scholar 

  23. Seider MJ, Rich TA, Ayala AG, Murray JA (1986) Giant cell tumors of bone: treatment with radiation therapy. Radiology 161:537–540

    Article  CAS  PubMed  Google Scholar 

  24. Mnaymneh WA, Dudley HR, Mnaymeh LG (1968) Giant cell tumor of bone: an analysis and follow-up of forty-one cases observed at the Massachusetts General Hospital between 1925 and 960. J Bone Joint Surg 46:63–75

    Google Scholar 

  25. Marcove RC, Weiss LD, Vaghaiwalla MR (1978) Cryosurgery in the treatment of giant cell tumors of bone. Cancer 41:957–969

    Article  CAS  PubMed  Google Scholar 

  26. Chen ZX, Gu DZ, Yu ZH, Qian TN, Huang YR, Hu YH, Gu XZ (1987) Radiation therapy of giant cell tumor of bone: analysis of 35 patients. Int J Radiat Oncol Biol Phys 12(3):329–334

    Article  Google Scholar 

  27. Goldenberg RR, Campbell CJ, Bonfiglio M (1970) Giant cell tumour of bone: an analysis of two hundred and eighteen cases. J. Bone Joint Surg 52(4):619–664

    CAS  PubMed  Google Scholar 

  28. Feigenberg SJ, Marcus RB Jr, Zlotecki RA, Scarborough MT, Berrey BH, Enneking WF (2003) Radiation therapy for giant cell tumors of bone. Clin Orthop Relat Res 411:207–216

    Article  PubMed  Google Scholar 

  29. Malone S, O’Sullivan B, Catton C, Bell R, Fornasier V, Davis A (1995) Long-term follow-up of efficacy and safety of megavoltage radiotherapy in high-risk giant cell tumors of bone. Int J Radiat Oncol Biol Phys 33(3):689–694

    Article  CAS  PubMed  Google Scholar 

  30. Chen ZX, Gu DZ, Yu ZH, Qian TN, Huang YR, Hu YH, Gu XZ (1986) Radiation therapy of giant cell tumor of bone: analysis of 35 patients. Int J Radiat Oncol Biol Phys 12(3):329–334

    Article  CAS  PubMed  Google Scholar 

  31. Sharma U, Malyappa RS, Gupta AK, Julka PK, Sharma SR (1990) Radiation treatment of osteoclastoma. Indian J Cancer 27:1–10

  32. Daugaard S, Johansen HF, Barfod G, Laustein G, Schiodt T, Lund B (1987) Radiation treatment of giant cell tumour of bone. Acta Oncol 26(1):41–43

    Article  CAS  PubMed  Google Scholar 

  33. Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri BA, Moreau G, Davis AM (2002) Giant cell tumor of long bone: a Canadian Sarcoma Group study. Clin Orthop Relat Res 397:248–258

    Article  PubMed  Google Scholar 

  34. Harwood AR, Fornaster VL, Rider WD (1977) Supervoltage irradiation in the management of giant cell tumor of bone. Radiology 125:223–226

    Article  CAS  PubMed  Google Scholar 

  35. Miszczyk L, Wydmanski J, Spindel J (2001) Efficacy of radiotherapy for giant cell tumor of bone: given either postoperatively or as sole treatment. Int J Radiat Oncol Biol Phys 49:1239–1242

    Article  CAS  PubMed  Google Scholar 

  36. Nair MK, Jyothirmayi R (1999) Radiation therapy in the treatment of giant cell tumor of bone. Int J Radiat Oncol Biol Phys 43:1065–1069

    Article  CAS  PubMed  Google Scholar 

  37. Richards GE, Singleton AC (1938) Giant-cell tumors of the spine: with reports of three cases. Radiology 30:43–51

    Article  Google Scholar 

  38. Windweyer BW, Woodyatt PB (1949) Osteoclastoma: a study of thirty-eight cases. J Bone Joint Surg Br 31:252–267

    Google Scholar 

  39. Goldenberg R, Campbell C, Bonfiglio M (1970) Giant cell tumour of bone: an analysis of two hundred and eighteen cases. J Bone Joint Surg 52-A:619–664

    Google Scholar 

  40. Donthineni R, Boriani L, Ofluoglu O, Bandiera S (2009) Metastatic behaviour of giant cell tumour of the spine. Int Orthop 33(2):497–501

    Article  PubMed Central  PubMed  Google Scholar 

  41. Balke M, Campanacci L, Gebert C (2010) Bisphosphonate treatment of aggressive primary, recurrent and metastatic giant cell tumor of bone. BMC Cancer 10:462

    Article  PubMed Central  PubMed  Google Scholar 

  42. Lin PP, Guzel VB, Moura MF, Wallace S, Benjamin RS, Weber KL, Morello FA, Gokaslan ZL, Yasko AW (2002) Long-term follow-up of patients with giant cell tumor of the sacrum treated with selective arterial embolization. Cancer 95:1317–1325

    Article  PubMed  Google Scholar 

  43. Hosalkar HS, Jones KJ, King JJ, Lackman RD (2007) Serial arterial embolization for large sacral giant-cell tumors: mid- to long-term results. Spine (Phila Pa 1976) 32:1107–1115

    Article  Google Scholar 

  44. Thomas D, Henshaw R, Skubitz K et al (2010) Denosumab in patients with giant-cell tumour of bone: an open-label, phase 2 study. Lancet Oncol 11:275–280

    Article  CAS  PubMed  Google Scholar 

  45. Chawla Sant, Henshaw Robert, Thomas David, Qian Yi, Jacobs Ira et al (2013) Safety and efficacy of denosumab for adults and skeletally mature adolescents with giant cell tumour of bone: interim analysis of an open-label, parallel-group, phase 2 study. Lancet Oncol 14:901–908

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by Shanghai youth science and technology talent sailing program (Grant 14YF1405900).

Conflict of interest

The authors disclose no conflicts.

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    Authors and Affiliations

    1. Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

      Yifei Ma, Wei Xu, Huabin Yin, Quan Huang, Tielong Liu, Xinghai Yang, Haifeng Wei & Jianru Xiao

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    1. Yifei Ma
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    2. Wei Xu
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    Correspondence to Haifeng Wei or Jianru Xiao.

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    Y. Ma, W. Xu and H. Yin contributed equally to this study.

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    Ma, Y., Xu, W., Yin, H. et al. Therapeutic radiotherapy for giant cell tumor of the spine: a systemic review. Eur Spine J 24, 1754–1760 (2015). https://doi.org/10.1007/s00586-015-3834-0

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    • DOI: https://doi.org/10.1007/s00586-015-3834-0

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