Giant cell tumor of bone

[xrt123]

Any one have thoughts on dose for a giant cell tumor of bone that rapidly recurred in cervical spine? Looking through the literature gives some pretty wide ranges of doses and only limited number of patients have been reported on.

Any thoughts are appreciated even if they lead to a tangent on the job market or ASTRO leadership.

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[thecarbonionangle]

Any chance for a radical surgery or referral to an aggressive ortho spine? Would treat to sarcoma/chordoma doses.

 

[napoleondynamite]

Radiosensitive! Treat as high as you safely can. I like SBRT (with no data). Id do something like 40/5 or take it as high as you can if standard fractionation - probably 54Gy/30

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[xrt123]

Reresected by neurosurgery but recurred too quickly to be a traditional giant cell. Path is being sent for multiple opinions but NSG wants radiation now. I'm too chicken for SBRT. THanks

 

[nkmiami]

I would radiate to whatever the spinal cord tolerance lets you.

 

[Palex80]

I agree. Whatever dose the spinal cord allows you to give is reasonable. I've treated one big tumor in the pelvis, irresectable. Locally controlled for a few years but then mets popped up.