Table 1.
Literature review of radiation used for the treatment of TGCT-D.
| Author/year | Location and number (PORT group) | Study Period | Follow-up (months) | Surgery | Radiotherapy | Recurrence (%, n) or other prognostic information | Main toxicities of radiotherapy |
| Yang 2019[12] | TMJ: 1 | 2016 | 24 | MiddleMiddle cranial fossa intracranial resection | IMRT: 40Gy/2Gy/20 F | 0% (0/1) | There were no serious toxicities after PORT. |
| Dürr 2019[13] | Knee: 26 | 1996–2014 | 49 | open synovectomy | RSO: 185 MBq (5 mCi) of 90Y-colloid was administered. | RSO: 23% (6 /26) Surgery-only: 27% (3/11) | Not reports. |
| Capellen 2018[5] | Knee: 29 | 1996–2014 | 71 | open synovectomy | RSO: 185 MBq (5 mCi) of 90Y-colloid was administered. EBRT: Not detailed. | RSO: 32% (7/27) EBRT: 0% (0/2) | One case of femoral condylar necrosis occurred because of repeated ROS. |
| Gortzak 2018[14] | Knee: 34 | 1991–2014 | 87.6 | Subtotal synovectomy | Adjuvant intra-articular injection of 90Yttrium | RSO: 44.1% (15 /34); Surgery-only: 50% (11/ 22) | Fourteen patients (41.2%) in the radiotherapy group developed degenerative changes at the x-ray. |
| Verspoor 2018[15] | TMJ: 2 | 2017 | 8-12 | Irradical resection | EBRT: 45Gy/1.8Gy/25 F | No evidence of progressive disease. | There were no serious toxicities after EBRT. |
| Guo 2018[16] | Ankle: 26 | 2004–2015 | 54 | Arthroscopic (10cases), Combined open synovectomy (16 cases) | 6-MV X-ray beam: 20Gy/2Gy/10 F | Arthroscopic: 0%; Combined open synovectomy group: 31% (5/16). | No complications of nerve or vascular damage wound or joint infection, or deep venous thrombosis were observed in any patient. |
| Duan 2018[17] | Knee: 1 | 2014 | 36 | Arthroscopic total synovectomy | 3DCRT: 30Gy/2Gy/15F | 0% (0/1) | No chronic toxic side effects such as joint activity limitation. |
| Serra 2017[18] | Shoulder: 1 | 2017 | 1 | Partial arthroscopic synovectomy | 15 and 6 MV photons: PTV∗ 40Gy/2.0Gy/20 F | 0% (0/1) | Only an acute grade I radiodermatitis and a mild, painless swelling during radiotherapy. |
| Li 2015[19] | Knee: 26 | 2006–2011 | 54 | Arthroscopic synovectomy | External radiotherapy: 20–30Gy/10F, once every other day. Two patients only completed 6Gy. | 0% (0/26) | No complications, such as infection and vein thrombosis, were noted. |
| Mollon 2016[20] | Knee: 11 | 1998–2011 | 81 | Combined synovectomies | EBRT: 35Gy/2.5Gy/14F; 40Gy/2Gy/20Gy+highest risk regions 8Gy/2Gy/4F | 12% (2/11) | One patient developed femoral condyle AVN and one lymphedema |
| Safaee 2014[21] | TMJ∗: 2 | 2007–2013 | 28 and 6 | One positive and one closed margin. | EBRT: 40Gy/2.0Gy/20 F and 45Gy/1.8Gy/25 F | 0% (0/2) | There were no serious toxicities after EBRT. |
| Joshi 2015[22] | TMJ: 2 | 2010 and 2012 | 24 and 48 | Incomplete synovectomy. | IMRT: 45Gy/1.8Gy/25 F | 0% (0/2) | There were no serious toxicities after radiotherapy. |
| Bruns 2013[23] | Unclear location: 10 | 1980–2002 | 152.4 | Unclear | RSO or RT | 0% (0/10)& | Unclear |
| Park 2012[24] | Knee: 23 | 1998–2007 | 108 | Unclear | 4-MV or 6-MV EBRT: median dose 20 (12–34) Gy /10F | 17.4% (4/23) | There were no serious toxicities (> grade 2) after radiotherapy. |
| Koca 2013[25] | Knee: 15 | 2006–2012 | 48±22 | Arthroscopic synovectomy | RSO: 5 mCi 90Y citrate colloid was injected into the joints. | No disease progression was found in all patients. | Unclear |
| Griffin 2012[26] | Hand:6,Wris:4,Hip:4,Knee:20,Ankle:9, Foot:7 | 1972–2006 | 94 | Unclear | EBRT (Cobalt-60, 4–6MV, 24–50Gy/13–25 F) | 6% (3/50) | Two patients required subsequent total hip arthroplasty because of progressive osteoarthritis. |
| Carvalho 2012[27] | Knee: 8 | 1997–2008 | 103 | Subtotal Synovectomy | 15-MV linear accelerated photon beam: 20Gy (10–39.6Gy)/10F | 12.5% (1/8) | Three patients had late minor complications. |
| Chen 2011[28] | Knee: 19 | 2001–2007 | 98 | Unclear | EBRT: 30Gy/2.0Gy/15 F | 10.5% (2/19); Residual tumor: 26.3% (5/19) | NO complications after radiotherapy. |
| Zook 2011[29] | Knee:8; Hip:1 | Unclear | 20 | Unclear | Intra-articular chromic phosphate (32P) | 30% (3/9) | During follow-up, there were no complications reported. |
| Judge 2011[30] | Ankle: 1 | 2003 | 96 | Arthroplasty of the ankle joint | EBRT: 34Gy/15 F | 0% (0/1) | Slight hyperpigmentation of the skin. |
IMRT = intensity-modulated radiation therapy, PORT = postoperative radiotherapy, TMJ = temporomandibular joint, RSO = adjuvant radiosynoviorthesis, EBRT = external beam radiation, F = fraction, 3DCRT = 3-dimensional conformal radiation therapy, PTV∗, defined as the whole synovial space and residual lesion as evidenced by a preoperative MRI plus a margin of 1 cm, AVN = avascular necrosis, TMJ∗, the temporomandibular joint with intracranial extension, RT = radiation therapy; &, ten patients who received ROS or RT after primary surgery did not show recurrence.