Radiotherapy for the Treatment of Giant Cell Tumor of the Spine: A Report of 3 Cases and Review of the Literature

Optimal treatment for giant cell tumors of the spine remains challenging. Surgical excision remains the initial treatment of choice, but the potential spinal cord injury may limit the extent of resection. Between 2001 and 2003, we report 3 patients diagnosed with giant cell tumor of spine treated with post-operative radiotherapy. Surgery consisted of subtotal resection of tumor. The involved vertebrae were then irradiated with doses ranging from 4500 to 6120 cGy. All patients tolerated the treatment well with no severe or chronic complications. Two of the 3 patients are alive with no evidence of disease. One is alive with recurrent disease upon regular MRI follow-up 24 months after treatment, although it is not clinically apparent. Our experience shown adjuvant radiotherapy after conservative surgery is a reasonable treatment alternative for tumors that cannot be completely excised or in which surgery would result in significant morbidity. Although there is no clear dose response, review of the literature suggest doses ranged from 3500 to 4500 cGy are safe and effective in controlling giant cell tumor.