RADIATION THERAPY FOR GIANT CELL TUMOR OF BONE: FOUR YOUNG FEMALE PATIENTS

Abstract

Of 125 patients with primary malignant bone tumor referred to us for radiotherapy from 1959 to 1989, 4 had previously untreated giant cell tumors of bone. To evaluate the usefullness of radiotherapy in giant cell tumors of bone, we investigated histology, type of surgery, radiation dosage, pain relief, reossification, and clinical course in these patients. Patients were all female, with ages ranging from 16 to 21 years (mean, 19 years). In 3 patients, the primary tumor sites were weight-bearing bone. Histopathologically, the tumors were grade I in 2 patients, and II or III in each of the other patients. Two patients were treated with radiation alone, and the others were irradiated pre-or post-operatively. Radiation doses ranged from 40 to 69 Gy. Pain relief was achieved in 3 patients, and subjective relief was obtained with a dose of less than 20 Gy. Reossification of affected bonewas recognized 3 to 5 months after completion of radiotherapy. Local control was obtained in 3 patients, although there was no significant relation between local control and tumor size. Follow-up periods ranged from 2 years and 2 months to 17 years, and all patients are still alive. Three show no evidence of disease, and 2 who had been diagnosed with histological grade I giant cell tumor have survived for long periods (17 and 15 years). At present, all local lesions are well controlled, and we have encountered no malignant transformation that might be attributable to radiation therapy. We conclude that radiation therapy is the treatment of first choice for inoperable giant cell tumor with primary lesion in the weightbearing bones, and that it is a curative alternative which preserves motor function.