External Beam Radiation Therapy Enhances Local Control in Pigmented Villonodular Synovitis

Melissa Horoschak, Phuoc T Tran, Pavan Bachireddy, Robert B. West, David Mohler, Christopher F. Beaulieu, Daniel S. Kapp, Sarah S. Donaldson

Research output: Contribution to journalArticle

Abstract

Purpose: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovium with locally aggressive behavior. We reviewed our experience using radiation therapy in the treatment of PVNS. Materials and Methods: Seventeen patients with 18 sites of PVNS were treated with radiation between 1993 and 2007. Cases were retrospectively reviewed for patient information, treatment parameters, complications, and outcome. Seven sites were primary presentations and 11 were recurrent with an average of 2.5 prior surgical interventions. The most common location was the knee joint (67%). Cytoreductive surgery was performed before radiation therapy in 16/18 sites with all having proven or suspected residual disease. Radiation was delivered using 4-15 MV photons with an average total dose 34 Gy (range, 20-36 Gy). Seventeen of 18 sites (94%) had postradiotherapy imaging. Results: With average follow-up of 46 months (range, 8-181 months), initial local control was achieved in 75% (12/16) of the sites with prior cytoreductive surgery (mean time to recurrence, 38 months). Ultimate local control was 100% after repeat resection (mean follow-up, 61 months). Two additional sites without prior cytoreductive surgery showed growth after radiotherapy (mean time to documented growth, 10.5 months). Seventeen of the 18 involved joints (94%) were scored as excellent or good PVNS-related function, one site (5%) as fair function, and no site with poor function. No patient required amputation; and there were no Grade 3/4 treatment-related complications. Conclusion: Postoperative external beam radiation is effective in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in PVNS.

Original languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume75
Issue number1
DOIs
StatePublished - Sep 1 2009
Externally publishedYes

Fingerprint

Pigmented Villonodular Synovitis
surgery
radiation therapy
Radiotherapy
Radiation
radiation
grade
Recurrence
disorders
Synovial Membrane
dosage
Growth
Knee Joint
Photons
Amputation
photons
Therapeutics
Joints

Keywords

  • Pigmented villonodular synovitis
  • Radiotherapy
  • Tenosynovial giant cell tumor

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

External Beam Radiation Therapy Enhances Local Control in Pigmented Villonodular Synovitis. / Horoschak, Melissa; Tran, Phuoc T; Bachireddy, Pavan; West, Robert B.; Mohler, David; Beaulieu, Christopher F.; Kapp, Daniel S.; Donaldson, Sarah S.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 75, No. 1, 01.09.2009, p. 183-187.

Research output: Contribution to journalArticle

Horoschak, Melissa ; Tran, Phuoc T ; Bachireddy, Pavan ; West, Robert B. ; Mohler, David ; Beaulieu, Christopher F. ; Kapp, Daniel S. ; Donaldson, Sarah S. / External Beam Radiation Therapy Enhances Local Control in Pigmented Villonodular Synovitis. In: International Journal of Radiation Oncology, Biology, Physics. 2009 ; Vol. 75, No. 1. pp. 183-187.
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abstract = "Purpose: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovium with locally aggressive behavior. We reviewed our experience using radiation therapy in the treatment of PVNS. Materials and Methods: Seventeen patients with 18 sites of PVNS were treated with radiation between 1993 and 2007. Cases were retrospectively reviewed for patient information, treatment parameters, complications, and outcome. Seven sites were primary presentations and 11 were recurrent with an average of 2.5 prior surgical interventions. The most common location was the knee joint (67{\%}). Cytoreductive surgery was performed before radiation therapy in 16/18 sites with all having proven or suspected residual disease. Radiation was delivered using 4-15 MV photons with an average total dose 34 Gy (range, 20-36 Gy). Seventeen of 18 sites (94{\%}) had postradiotherapy imaging. Results: With average follow-up of 46 months (range, 8-181 months), initial local control was achieved in 75{\%} (12/16) of the sites with prior cytoreductive surgery (mean time to recurrence, 38 months). Ultimate local control was 100{\%} after repeat resection (mean follow-up, 61 months). Two additional sites without prior cytoreductive surgery showed growth after radiotherapy (mean time to documented growth, 10.5 months). Seventeen of the 18 involved joints (94{\%}) were scored as excellent or good PVNS-related function, one site (5{\%}) as fair function, and no site with poor function. No patient required amputation; and there were no Grade 3/4 treatment-related complications. Conclusion: Postoperative external beam radiation is effective in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in PVNS.",
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AB - Purpose: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovium with locally aggressive behavior. We reviewed our experience using radiation therapy in the treatment of PVNS. Materials and Methods: Seventeen patients with 18 sites of PVNS were treated with radiation between 1993 and 2007. Cases were retrospectively reviewed for patient information, treatment parameters, complications, and outcome. Seven sites were primary presentations and 11 were recurrent with an average of 2.5 prior surgical interventions. The most common location was the knee joint (67%). Cytoreductive surgery was performed before radiation therapy in 16/18 sites with all having proven or suspected residual disease. Radiation was delivered using 4-15 MV photons with an average total dose 34 Gy (range, 20-36 Gy). Seventeen of 18 sites (94%) had postradiotherapy imaging. Results: With average follow-up of 46 months (range, 8-181 months), initial local control was achieved in 75% (12/16) of the sites with prior cytoreductive surgery (mean time to recurrence, 38 months). Ultimate local control was 100% after repeat resection (mean follow-up, 61 months). Two additional sites without prior cytoreductive surgery showed growth after radiotherapy (mean time to documented growth, 10.5 months). Seventeen of the 18 involved joints (94%) were scored as excellent or good PVNS-related function, one site (5%) as fair function, and no site with poor function. No patient required amputation; and there were no Grade 3/4 treatment-related complications. Conclusion: Postoperative external beam radiation is effective in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in PVNS.

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