Table 4.
Published case reports on radiotherapy for GS
| Study | Patient no. | Age | Cytogenetics | Underlying disease | Timing of GS emergence | Radiotherapy site | Dose fractionation | Response |
|---|---|---|---|---|---|---|---|---|
| Lee et al.
[25] |
1 |
50 |
t(9;22)(q34;q11) |
CML |
Relapse after BMT, BM (-) |
Clavicle and manubrium |
15 Gy |
CR |
| Taverna et al.[26] |
1 |
62 |
- |
AML-M4 |
Relapse after chemotherapy, BM also (+) |
Left gluteal and the deeper pelvic muscles |
20 Gy/10fx |
PR |
| Au et al.[27] |
1 |
24 |
del( 5)(q13; q33) |
AML-M0 |
Relapse after BMT, BM (-) |
Left breast |
30 Gy |
PD |
| Pulsoni et al.[28] |
1 |
84 |
- |
De novo sarcoma |
At presentation, BM (-) |
Skin |
90 Gy/8fx |
CR |
| Kasahara et al.[29] |
1 |
47 |
der (1; 7)(q10; p 10) |
Idiopathic myelofibrosis and de novo sarcoma |
At presentation, BM (-) |
Right submandibular tumor |
30 Gy |
CR |
| Buckland et al.[30] |
1 |
35 |
Normal karyotype |
De novo sarcoma |
At presentation, BM (-) |
C4-6 spine |
32 Gy/16fx |
CR |
| Lee at al.[31] |
1 |
43 |
- |
De novo sarcoma |
At presentation, BM (-) |
Maxillary gingiva |
36 Gy |
CR |
| Fleckenstein et al.[32] |
1 |
73 |
Normal karyotype |
AML |
Found at initial presentation with BM (+) |
Bilateral retrobulbar tumor |
30 Gy/15fx |
CR |
| Cozzi et al.[33] |
1 |
39 |
Philadelphia positive |
CML |
Chronic phase |
Left shoulder |
21 Gy |
PD |
| Nishimura et al.[34] |
1 |
30 |
Add(3)(q27), t(8;21)(q22,q22) |
AML-M2 |
Relapse after BMT, BM (-) |
Right frontal intra/extracranial tumor |
16 Gy |
CR |
| Pelosini et al.[35] |
1 |
25 |
t(8,21)with AML1-ETO expression. |
AML-M0 |
Relapse after BMT, BM (-) |
Left leg |
40 Gy |
CR |
| Rosenberg et al.[36] |
1 |
8 |
del(7)(q22;q36),t(7;11)(p15;p15) |
AML-M2 |
Relapse after BMT, BM also (+) |
Bilateral synchronous epibulbar tumor |
24 Gy/12fx |
CR |
| Pitz et al.[37] |
1 |
50 |
Normal karyotype |
AML |
Relapse after chemotherapy, BM also (+) |
Uterus/ endometrium |
30 Gy/10fx |
CR |
| Kumar et al.[38] |
1 |
10 |
- |
De novo sarcoma |
At presentation, BM (-) |
Left orbit |
24 Gy/12fx |
CR |
| Vassiliou et al.[39] |
1 |
40 |
- |
De novo sarcoma |
At presentation, BM (-) |
Mediastinal lymph node |
41.4 Gy/23fx |
CR |
| Kozelj et al.[40] |
1 |
52 |
t(8;21) |
AML |
At presentation, BM (+) |
Heart |
15 Gy/10fx |
CR |
| Lee et al.[41] |
1 |
25 |
45,X,-Y,del(2)(q21q31),t(5;11)(q31;q13),t(8;21)(q22;q22),t(10;19)(q22;q13.1) |
De novo sarcoma |
At presentation, BM (-) |
Orbit |
70 Gy |
PR |
| Mauermann et al.[42] |
1 |
70 |
Normal karyotype |
De novo sarcoma |
At presentation, BM (-) |
Base of the skull to the upper thoracic region, including the brachial plexus |
20 Gy/10fx |
Good PR |
| Verra et al.
[43] |
1 |
45 |
inv(16) |
AML-M4 |
Relapse after BMT, BM (-) |
L4 to S3 spine |
21 Gy/7fx |
PR |
| Antic et al.[44] |
1 |
24 |
Normal karyotype |
De novo sarcoma |
At presentation, BM (-) |
Lumbosacral spine |
40 Gy/20fx |
CR |
| Mignano et al.[45] |
1 |
20 |
- |
AML-M2 |
Relapse after BMT, BM (-) |
Left jaw |
30 Gy/15fx |
CR |
| |
|
|
|
|
|
Heart |
24 Gy/12fx |
CR |
| Kim et al.[16] |
1 |
30 |
- |
De novo sarcoma |
At presentation, BM (-) |
Uterus/cervix |
30 Gy |
CR |
| Alvarez et al.[46] |
1 |
41 |
CBFβ/MYH11 fusion and inv(16) (p13q22) |
AML-M2 |
At initial presentation, BM also (+) |
Small bowel, greater omentum and peritoneum |
22.4 Gy/14fx |
CR |
| Masetti et al.[47] |
1 |
11 |
11q23 rearrangement (MLL-AF10) |
AML-M5 |
In remission after allogeneic hematopoietic stem cell transplantation, BM (-) |
L1 to S3 Epidural mass |
20 Gy/16fx |
Good PR at the end of RT |
| Chak et al.[5] |
33 (54 courses of radiotherapy) |
1.5 - 8 1 |
- |
28 (84.8%) acute non-lymphocytic leukemia, 11 (15.2%) chronic leukiemia |
- |
33% bone, 31% soft tissue, 11% lymph node, 7% spinal cord, 6% brain, 11% other sites (Mediastinal mass, 2; pelvic mass, 1; pleural mass, 1 ; spleen, 1 ; porta hepatis, I) |
|
<1000 rad, CR 18%, 1000–1999 rad, CR 43%; 2000–2900 rad, CR 86%; >3000 rad, CR 89% |
| Bakst et al.[9] | 22 (33 courses of radiotherapy) | Median 34 (1–71) | - | AML 19 (86%), MDS 2 (9%), Isolated Chloroma 1 (5%) | 32% in remission (43% of them have GS concomitantly with marrow relapse) | 39% head and neck, 24% extremity, 9% spine, 9% brain, 6% genito-urinary, 6% breast, 3% pelvis, and 3% genitourinary | Median 20 (6–36) Gy/2 Gy (1.5–4 Gy) | CR 97% |
Abbreviations: BM = bone marrow; CR = complete response; fx = fraction; Gy = gray; PD = progressive disease; PR = partial response.