3-D-conformal radiation therapy for pediatric giant cell tumors of the skull base

Eugen B. Hug, Marc W. Muenter, Judy A. Adams, Alexander De Vries, Andrew Rosenberg, John E. Munzenrider

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Giant cell tumors (GCT) of the base of skull are rare neoplasms. This report reviews the treatment of four pediatric patients presenting with aggressive giant cell tumor, using fractionated and combined, conformal proton and photon radiation therapy at Massachusetts General Hospital and Harvard Cylcotron Laboratory. Patients and Methods: Three female patients and one adolescent male, ages 10-15 years, had undergone prior, extensive surgical resection(s) and were treated for either primary (two patients) or recurrent (two patients) disease. Gross residual tumor was evident in three patients and microscopic disease suspected in one patient. Combined proton and photon radiation therapy was based on three-dimensional (3-D) planning, consisting of fractionated treatment, one fraction per day at 1.8 CGE (cobalt-gray equivalent) to total target doses of 57.6, 57.6, 59.4, and 61.2 Gy/CGE. Results: With observation times of 3.1 years, 3.3, 5.3, and 5.8 years, all four patients were alive and well and remained locally controlled without evidence of recurrent disease. Except for one patient with partial pituitary insufficiency following radiotherapy for sellar recurrent disease, thus far no late effects attributable to radiation therapy have been observed. Conclusions: 3-D-conformal radiation therapy offers a realistic chance of tumor control for aggressive giant cell tumor in the skull base, either postoperatively or at time of recurrence. Conformal treatment techniques allow the safe delivery of relatively high radiation doses in the pediatric patient without apparent increase of side effects.

Original languageEnglish
Pages (from-to)239-244
Number of pages6
JournalStrahlentherapie und Onkologie
Volume178
Issue number5
DOIs
StatePublished - May 30 2002
Externally publishedYes

Fingerprint

Giant Cell Tumors
Skull Base
Radiotherapy
Pediatrics
Cobalt
Photons
Skull Base Neoplasms
Protons
Hypopituitarism
Residual Neoplasm
General Hospitals
Therapeutics
Observation
Radiation
Recurrence

Keywords

  • Base of skull neoplasms
  • Charged particle therapy
  • Giant cell tumor
  • Pediatric neoplasm
  • Protons

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research
  • Radiological and Ultrasound Technology

Cite this

3-D-conformal radiation therapy for pediatric giant cell tumors of the skull base. / Hug, Eugen B.; Muenter, Marc W.; Adams, Judy A.; De Vries, Alexander; Rosenberg, Andrew; Munzenrider, John E.

In: Strahlentherapie und Onkologie, Vol. 178, No. 5, 30.05.2002, p. 239-244.

Research output: Contribution to journalArticle

Hug, Eugen B. ; Muenter, Marc W. ; Adams, Judy A. ; De Vries, Alexander ; Rosenberg, Andrew ; Munzenrider, John E. / 3-D-conformal radiation therapy for pediatric giant cell tumors of the skull base. In: Strahlentherapie und Onkologie. 2002 ; Vol. 178, No. 5. pp. 239-244.
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AB - Background: Giant cell tumors (GCT) of the base of skull are rare neoplasms. This report reviews the treatment of four pediatric patients presenting with aggressive giant cell tumor, using fractionated and combined, conformal proton and photon radiation therapy at Massachusetts General Hospital and Harvard Cylcotron Laboratory. Patients and Methods: Three female patients and one adolescent male, ages 10-15 years, had undergone prior, extensive surgical resection(s) and were treated for either primary (two patients) or recurrent (two patients) disease. Gross residual tumor was evident in three patients and microscopic disease suspected in one patient. Combined proton and photon radiation therapy was based on three-dimensional (3-D) planning, consisting of fractionated treatment, one fraction per day at 1.8 CGE (cobalt-gray equivalent) to total target doses of 57.6, 57.6, 59.4, and 61.2 Gy/CGE. Results: With observation times of 3.1 years, 3.3, 5.3, and 5.8 years, all four patients were alive and well and remained locally controlled without evidence of recurrent disease. Except for one patient with partial pituitary insufficiency following radiotherapy for sellar recurrent disease, thus far no late effects attributable to radiation therapy have been observed. Conclusions: 3-D-conformal radiation therapy offers a realistic chance of tumor control for aggressive giant cell tumor in the skull base, either postoperatively or at time of recurrence. Conformal treatment techniques allow the safe delivery of relatively high radiation doses in the pediatric patient without apparent increase of side effects.

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