Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

Bhatia, Sumita; Miszczyk, Leszek; Roelandts, Martine; Nguyen, Tan Dat; Boterberg, Tom; Poortmans, Phillip; Vallow, Laura A.; Dinçbaş, Fazilet Öner; Lassen‐Ramshad, Yasmin; Botros, Maikel; Miller, Robert C.

doi:10.4081/rt.2011.e48

Cited by 27 publications

(19 citation statements)

References 10 publications

(16 reference statements)

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“…The role of primary radiotherapy for the treatment of these tumors is controversial due to earlier reports that GCTs could turn malignant after radiotherapy [Glasscock and Hunt, 1974]. A multiinstitutional study of 58 patients with GCTs treated by radiotherapy in European and North American academic centers by Bhatia et al [2011] reported no malignant transformation in any of the cases. They reported 5-year overall survival of 94% and 5-year disease-free survival of 81%.…”

Section: Surgical Managementmentioning

confidence: 99%

Giant Cell Tumors of the Skull Base: Case Series and Current Concepts

Prasad

Piccirillo²,

Nuseir

et al. 2013

Audiol Neurotol

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Objective: To study the clinical features, tumor characteristics and outcomes of giant cell tumors (GCTs) in the skull base based on long-term follow-up. We also report the largest series of GCTs in the temporal bone and the lateral skull base. Materials and Methods: A retrospective study was conducted of all GCTs managed at the Gruppo Otologico, a quaternary referral skull base institute, in Italy from 1993 to 2013. The clinical features, investigations, surgical management and follow-up were recorded. The surgical approaches used were infratemporal fossa approach (ITFA) type B and D and middle cranial fossa (MCF) approaches. Results and Observations: A total of 7 patients with GCTs of the skull base were treated at our institution. The principal complaints were hearing loss reported in 6 (85.71%) patients, tinnitus in 5 (71.43%) and swelling in 3 (42.9%). Pure-tone audiometry showed conductive hearing loss in 5 (71.43%) patients. High-resolution CT scan and MRI with gadolinium enhancement were done in all patients. Radiology showed involvement of the ITF and middle ear in 6 (85.71%) patients each, temporomandibular joint in 4 (57.14%) patients, invasions of the squamous part of the temporal bone, mastoid, MCF and greater wing of sphenoid in 3 (42.9%) patients each and the petrous bone in 2 (28.6%) patients. ITFA type B was applied as an approach for tumor removal in 5 (71.43%) patients, including a case where an additional MCF approach was employed, and ITFA type D and the transmastoid approach were applied in 1 (14.3%) patient each. Total tumor removal and successful cure was achieved in 6 (85.71%) patients. Subtotal removal leading to recurrence and eventual mortality was the result in 1 (14.3%) patient. Conclusions: A thorough knowledge of the anatomy of the skull base and the various skull base approaches is necessary to tackle GCTs. ITFA type B and D combined with MCF approaches provide good exposure of the tumor with minimal postoperative sequelae and good locoregional control. Recurrence due to either subtotal removal or suboptimal treatment may have disastrous consequences for the patient.

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Section: Surgical Managementmentioning

confidence: 99%

Giant Cell Tumors of the Skull Base: Case Series and Current Concepts

Prasad

Piccirillo²,

Nuseir

et al. 2013

Audiol Neurotol

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“…To reduce the risk of recurrence, aggressive surgical approaches (joint resection, amputation, hemipelvectomy) are often applied. For unresectable GCTB patients, radiotherapy and serial embolization can relieve the symptoms for a short period, but the duration of effect is limited (13). Moreover, malignant transformation can occur after radiation (14).…”

Section: Introductionmentioning

confidence: 99%

Bortezomib Inhibits Giant Cell Tumor of Bone through Induction of Cell Apoptosis and Inhibition of Osteoclast Recruitment, Giant Cell Formation, and Bone Resorption

Luo

Jin

et al. 2016

Molecular Cancer Therapeutics

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Giant cell tumor of bone (GCTB) is a rare and highly osteolytic bone tumor that usually leads to an extensive bone lesion. The purpose of this study was to discover novel therapeutic targets and identify potential agents for treating GCTB. After screening the serum cytokine profiles in 52 GCTB patients and 10 normal individuals using the ELISA assay, we found that NF-kB signaling-related cytokines, including TNFa, MCP-1, IL1a, and IL17A, were significantly increased in GCTB patients. The results were confirmed by IHC that the expression and activity of p65 were significantly increased in GCTB patients. Moreover, all of the NF-kB inhibitors tested suppressed GCTB cell growth, and bortezomib (Velcade), a well-known proteasome inhibitor, was the most potent inhibitor in blocking GCTB cells growth. Our results showed that bortezomib not only induced GCTB neoplastic stromal cell (NSC) apoptosis, but also suppressed GCTB NSC-induced giant cell differentiation, formation, and resorption. Moreover, bortezomib specifically suppressed GCTB NSC-induced preosteoclast recruitment. Furthermore, bortezomib ameliorated GCTB cellinduced bone destruction in vivo. As a result, bortezomib suppressed NF-kB-regulated gene expression in GCTB NSC apoptosis, monocyte migration, angiogenesis, and osteoclastogenesis. Particularly, the inhibitory effects of bortezomib were much better than zoledronic acid, a drug currently used in treating GCTB, in our in vitro experimental paradigms. Together, our results demonstrated that NF-kB signaling pathway is highly activated in GCTB, and bortezomib could suppress GCTB and osteolysis in vivo and in vitro, indicating that bortezomib is a potential agent in the treatment of GCTB.

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“…This is because it mostly occurred in the epiphysis or metaepiphyseal location with extension to subchondral bone and the most commonly affected region is the knee which was about 50-55 %. 2,5 In this study, the very rare site of GCT of bone even occurs in one patient each, affecting zygoma, mandibular, vertebrae and distal tibia. Besides that, there are only four patients with GCT affecting the rare site, the bones of the feet.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Giant Cell Tumor in Dr. Hasan Sadikin General Hospital Bandung from 2010-2013

Gunasegaran¹,

Irawan²,

Yantisetiasti³

2016

amj

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Background: Giant cell tumor (GCT) of bone is a primary bone tumor. It is commonly seen in South East Asia and found in female around 20-45 years old. The GCT mostly occurs in epiphysis around the knee. The patients normally suffer from pain, swelling, limitation of joint movement, and pathologic fracture. This study aimed to determine the epidemiology of GCT of the bone based on age, sex, location, type, metastases, and recurrence in Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study with retrospective cohort using total sampling method was used to obtain 33 medical records of patients with GCT of bone in Department of Orthopedic & Traumatology and Anatomical Pathology Dr. Hasan Sadikin General Hospital Bandung in the period of January 2010-December 2013. Results: The GCT of bone was mostly found in female of 20 to 29 years old and around 32 years old in male. Distal femur will be the most common site while zygoma, mandibular vertebrae, proximal tibia were rare sites. Twenty nine cases were benign lesion and the rest (4 cases) were malignant. The probability of GCT of bone to metastasize to lungs was very low. Four recurrences occurred within a year. Conclusions: The GCT of bone in male mostly occurs in the third and fourth decade of age. It is found around the knee, mostly benign, rarely metastasize to the lungs and recurrence happens within a year. [AMJ.2016;3(2):244-7]

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Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

Cited by 27 publications

References 10 publications

Giant Cell Tumors of the Skull Base: Case Series and Current Concepts

Giant Cell Tumors of the Skull Base: Case Series and Current Concepts

Bortezomib Inhibits Giant Cell Tumor of Bone through Induction of Cell Apoptosis and Inhibition of Osteoclast Recruitment, Giant Cell Formation, and Bone Resorption

Epidemiology of Giant Cell Tumor in Dr. Hasan Sadikin General Hospital Bandung from 2010-2013

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