Pigmented Villonodular Synovitis (PVNS)

Oppenkowski, Ralf; Seegenschmiedt, M. H.

doi:10.1007/978-3-540-68943-0_21

Cited by 3 publications

(8 citation statements)

References 29 publications

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“…Overall, the retrospective case series ( n = 154) could demonstrate a local control rate of up to 100% when using total RT doses of 20–50 Gy. 54 The German PCS ( n = 41) yielded a local control rate of 95% with total RT doses of 20–50 Gy. 55 …”

Section: Resultsmentioning

confidence: 99%

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Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines

Seegenschmiedt

Micke

Muecke

2015

BJR

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Every year in Germany about 50,000 patients are referred and treated by radiotherapy (RT) for “non-malignant disorders”. This highly successful treatment is applied only for specific indications such as preservation or recovery of the quality of life by means of pain reduction or resolution and/or an improvement of formerly impaired physical body function owing to specific disease-related symptoms. Since 1995, German radiation oncologists have treated non-malignant disorders according to national consensus guidelines; these guidelines were updated and further developed over 3 years by implementation of a systematic consensus process to achieve national upgraded and accepted S2e clinical practice guidelines. Throughout this process, international standards of evaluation were implemented. This review summarizes most of the generally accepted indications for the application of RT for non-malignant diseases and presents the special treatment concepts. The following disease groups are addressed: painful degenerative skeletal disorders, hyperproliferative disorders and symptomatic functional disorders. These state of the art guidelines may serve as a platform for daily clinical work; they provide a new starting point for quality assessment, future clinical research, including the design of prospective clinical trials, and outcome research in the underrepresented and less appreciated field of RT for non-malignant disorders.

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Section: Resultsmentioning

confidence: 99%

“…With regard to RT concept, single RT doses of 1.8–2.0 Gy with five fractions per week are recommended; in case of a diffuse type (D-PVNS) lesion, total RT doses should reach 36–40 Gy, whereas in cases of a localized type (L-PNVS) and of PVTS total RT doses of 30–36 Gy are considered sufficient. 54 – 56 …”

Section: Resultsmentioning

confidence: 99%

Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines

Seegenschmiedt

Micke

Muecke

2015

BJR

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“…The above phantom was used together with the Monte Carlo model of the medical linear accelerator in order to simulate radiation therapy for PVNS in the knee and hip regions. These are the two most common regions affected by PVNS (Oppenkowski and Seegenschmiedt 2008). The leg structure of the original phantom was properly modified to separate the two limbs and simulate the real patient's irradiation in the knee joint (Berris et al 2014).…”

Section: Monte Carlo Simulationsmentioning

confidence: 99%

“…A patient's irradiation may be used as an independent treatment for diffuse PVNS but it is mostly applied postoperatively in order to reduce the aforementioned increased relapse rates (Murphey et al 2008). The intra-articular injection of radionuclides such as 90-yttrium or 32-phosphorus may be employed only to lesions at shallow depths because of the small treatment range of these beta-emitters (Oppenkowski and Seegenschmiedt 2008). The high energy x-ray beams generated by a linear accelerator may be used for the management of PVNS without being limited by the depth of the treatment site.…”

Section: Introductionmentioning

confidence: 99%

“…The high energy x-ray beams generated by a linear accelerator may be used for the management of PVNS without being limited by the depth of the treatment site. Externalbeam radiotherapy may enhance the local control of the disease and improve the function of the affected joints (Mendenhall et al 2006, Oppenkowski andSeegenschmiedt 2008). The early and late toxicity in exposed patients has been characterized as mild (Heyd et al 2010).…”

Section: Introductionmentioning

confidence: 99%

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Organ-specific radiation-induced cancer risk estimates due to radiotherapy for benign pigmented villonodular synovitis

et al. 2016

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Pigmented villonodular synovitis (PVNS) is a benign disease affecting synovial membranes of young and middle-aged adults. The aggressive treatment of this disorder often involves external-beam irradiation. This study was motivated by the lack of data relating to the radiation exposure of healthy tissues and radiotherapy-induced cancer risk. Monte Carlo methodology was employed to simulate a patient's irradiation for PVNS in the knee and hip joints with a 6 MV photon beam. The average radiation dose received by twenty-two out-of-field critical organs of the human body was calculated. These calculations were combined with the appropriate organ-, age- and gender-specific risk coefficients of the BEIR-VII model to estimate the lifetime probability of cancer development. The risk for carcinogenesis to colon, which was partly included in the treatment fields used for hip irradiation, was determined with a non-linear mechanistic model and differential dose-volume histograms obtained by CT-based 3D radiotherapy planning. Risk assessments were compared with the nominal lifetime intrinsic risk (LIR) values. Knee irradiation to 36 Gy resulted in out-of-field organ doses of 0.2-24.6 mGy. The corresponding range from hip radiotherapy was 1.2-455.1 mGy whereas the organ equivalent dose for the colon was up to 654.9 mGy. The organ-specific cancer risks from knee irradiation for PVNS were found to be inconsequential since they were at least 161.5 times lower than the LIRs irrespective of the patient's age and gender. The bladder and colon cancer risk from radiotherapy in the hip joint was up to 3.2 and 6.6 times smaller than the LIR, respectively. These cancer risks may slightly elevate the nominal incidence rates and they should not be ignored during the patient's treatment planning and follow-up. The probabilities for developing any other solid tumor were more than 20 times lower than the LIRs and, therefore, they may be considered as small.

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DEGRO guidelines for the radiotherapy of non-malignant disorders

Seegenschmiedt¹,

Micke

Niewald

et al. 2015

Strahlenther Onkol

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The use of RT can be recommended for the interdisciplinary management of most of the reported disorders. It can be used in the primary treatment approach and as an effective adjunct to other treatment modalities or in some indications as a valuable alternative treatment option. We hope that the updated DEGRO S2e consensus guideline recommendations are a helpful tool for radiation oncologists in the clinical decision-making process.

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Pigmented Villonodular Synovitis (PVNS)

Cited by 3 publications

References 29 publications

Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines

Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines

Organ-specific radiation-induced cancer risk estimates due to radiotherapy for benign pigmented villonodular synovitis

DEGRO guidelines for the radiotherapy of non-malignant disorders

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