Risk of Malignant Transformation of Giant Cell Tumors of Bone Is 8 Times Lower with Megavoltage vs. Orthovoltage Radiation Therapy

Table 1

Patient, radiation, and tumor characteristics of the included studies.

First author (year)	No. of tumors	Mean (range) age at diagnosis, yr	Range of radiation dose, Gy	Radiation only (n)	Radiation timing (n)		GCTB (n)
					Preoperative	Postoperative	Primary	Recurrent	Metastatic
Megavoltage
Ruka [16] (2010)	77	28 (16–69)	26–89	77	0	0	56	21	0
Bhatia [17] (2011)	58	31 (12–84)	20–65	13	0	42	45	13	0
Shi [14] (2013)	34	29 (16–85)	35–55	21	0	13	22	12	0
Sharma [11] (1990)	30	27 (18–40)	45–55	30	0	0	30	0	0
Feigenberg [13] (2003)	26	35 (16–75)	35–55	15	0	11	16	10	0
Caudell [4] (2003)	25	32 (11–69)	25–65	14	0	11	13	12	0
Malone [15] (1995)	21	32 (13–71)	11–50	7	0	14	13	8	0
Chakravati [8] (1999)	20	39 (15–72)	40–70	7	0	13	15	4	1
Nair [3] (1999)	20	33 (15–65)	40–60	20	0	0	14	6	0
Bennett [10] (1993)	16	35 (16–75)	35–54	16	0	0	10	6	0
Bell [9] (1983)	15	28 (13–49)	33–55	15	0	0	11	4	0
Schwartz [19] (1989)	13	45 (15–63)	42–68	8	0	5	7	3	3
Seider [20] (1986)	9	34 (12–63)	36–66	1	0	8	9	0	0
Daugaard [12] (1987)	8	38 (22–62)	30–75	0	1	7	6	2	0
JHH	6	48 (31–60)	50–60	0	0	6	2	4	0
Khan [18] (1999)	6	47 (16–71)	30–54	1	0	5	6	0	0
Roeder [21] (2010)	5	37 (20–60)	57–64	3	0	2	3	2	0
Walter [22] (1960)	4	35 (16–49)	30–44	3	0	1	4	0	0
Orthovoltage
Bradshaw [25] (1964)	50	NA (7–66)	20–60	23	8	19	50	0	0
Dahlin [24] (1970)	36	NA	NA	7	0	29	7	29	0
Windeyer [26] (1949)	29	NA (8–62)	2000–6000^†	19	0	10	29	0	0
McGrath [27] (1972)	21	NA	3000–9500^†	12	0	9	16	5	0
Mnaymneh [23] (1964)	16	31 (12–44)	2400–5400^†	6	0	10	9	7	0
Walter [22] (1960)	12	39 (17–67)	20–44	11	1	0	12	0	0
Daugaard [12] (1987)	2	36 (35–37)	23–24	0	0	2	2	0	0
Seider [20] (1986)	2	35 (34–36)	2100–4500^†	0	0	2	2	0	0

GCTB, giant cell tumor of bone; JHH, Johns Hopkins Hospital patients; NA, not available. Expressed as median (range). ^†Unit of measure is Roentgen.