2002 CTOS Annual Meeting Posters — Radiation Oncology

RADIATION THERAPY IN THE MANAGEMENT OF GIANT CELL TUMOR OF BONE
[Abstract ID: 34]

Category: Radiation Oncology

Authors: James J Caudell¹, Matthew T Ballo¹, Gunar K Zagars¹, Valerae O Lewis¹, Rex A Marco¹, Kristin L Weber¹, Patrick P Lin¹, Robert S Benjamin¹, Adel K El-Naggar¹, Alan W Yasko¹

Author Institutions: ¹UT MD Anderson Cancer Center, United States

Presenter: James J Caudell
jcaudell@mdanderson.org

Correspondent: Matthew T Ballo
mballo@mdanderson.org
Houston Texas United States 77030
Ph: 713-792-3400
Fax: 713-794-5573

Objectives: To evaluate the outcome for giant cell tumor of bone treated with radiation therapy, with or without surgical resection.

Methods: A retrospective review of 25 consecutive patients with pathologically confirmed giant cell tumor of bone receiving radiation therapy.

Results: The anatomic distribution of lesions was as follows: cervical spine, 3; temporal bone, 1; thoracic or lumbar spine, 9; sacrum, 8; iliac, 1; and one each in the humerus, radius, and 1st metacarpal bone. Tumor size ranged from 2-20 cm (median, 9.5 cm). Twelve patients were referred with recurrent disease having undergone one or more prior surgical resections or had been heavily pretreated using chemo-embolization with subsequent recurrence. Fourteen patients were treated for gross disease, the remaining eleven were treated after gross total surgical resection. The dose for radiation was 46 Gy (range 25-65 Gy). Median follow up was 8.8 years (0.67-34 years). The actuarial 5-year OS and DFS were 91% and 58%, respectively. The actuarial 5-year LC and DMFS rates were 62% and 81%, respectively. Univariate analysis suggested that treatment for recurrent disease correlated with an inferior DFS (33% vs. 83%, p=0.06), DMFS (64% vs. 100%, p=0.08), and LC rate (42% vs. 83%, p=0.08) at 5 years. Additionally, there was an inferior OS rate in those patients treated with radiation alone (80% vs. 100%, p=0.04).

Conclusions: Primary GCT of bone is a radiosensitive tumor. Radiation should be considered as an adjuvant to surgery or as an alternative in cases where excision would result in significant functional deficits.