Radiotherapy of Morbus Gorham—Stout: the biological value of low irradiation dose

Abstract

Morbus Gorham-Stout is a very rare disease. A patient with this disease was treated at the University Clinic of Radiobiology in Vienna. The clinical and radiological findings place special emphasis on the radiotherapeutic treatment, and the biological basis of the recommended dose is discussed.

Gorham's Disease or Massive Osteolysis

“…The non-operative options include radiation therapy, 10,21,39,44,60,69,101,112,139,140 anti-osteoclastic medication (bisphosphonates), 109,146 and alpha-2b interferon. 109 The operative options include surgical resection, 10,29,63,69 reconstruction using a bone graft, 30,63 or a prosthesis.…”

“…The medical treatment for Gorham's disease includes radiation therapy, 10,21,39,44,60,69,101,112,139,140 anti-osteoclastic medication (bisphosphonates), 109,146 and alpha-2b interferon. 109 The principal treatment modalities are surgery and radiation therapy.…”

A Case of Gorham's Disease with Chylothorax Treated Curatively with Radiation Therapy

“…Early use of radiation therapy may arrest endothelial cell proliferation, and thereby limit the spread of disease and allow the patient to avoid relatively complicated surgery with its inherent risks. 7,26 Radiation therapy may also be used successfully in patients who are poor surgical candidates, such as the patient presented in this report, and patients who have failed surgical treatments. Finally, there have been reports of recalcification of affected bone following radiation therapy, a phenomenon that is exceedingly rare with other treatment modalities.…”

“…8,9,20 For patients with Gorham's disease with or without chylothorax, radiation therapy has been used with mixed success. 2,8,9,11,20,[23][24][25][26] Using escalating doses of radiation to treat Gorham's disease assists in the eradication of increasing numbers of radiosensitive proliferating endothelial cells. 26 Once an adequate dose has been reached, clones derived from remaining viable cells are spaced too irregularly to form an occlusive vessel.…”

“…2,8,9,11,20,[23][24][25][26] Using escalating doses of radiation to treat Gorham's disease assists in the eradication of increasing numbers of radiosensitive proliferating endothelial cells. 26 Once an adequate dose has been reached, clones derived from remaining viable cells are spaced too irregularly to form an occlusive vessel. Moderate doses of 25-45 Gy have been reported as effective.…”