gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Radiotherapy for Bony Manifestations of Langerhans Cell Histiocytosis

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Thomas Olschewski - Alfried-Krupp-Krankenhaus, Essen, Deutschland
  • Michael-Heinrich Seegenschmiedt - Alfried-Krupp-Krankenhaus, Essen

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocIS080

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Veröffentlicht: 20. März 2006

© 2006 Olschewski et al.
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Langerhans cell histiocytosis (LCH) is a rare disorder caused by an uncontrolled clonal proliferation of Langerhans cells. So far, the onset and the transformation to a pathologic growth-pattern remain unclear. LCH involves one ("single-system disease") or multiple ("multi-system disease") organs. Up to 60% of patients (pt.) with LCH develop bony lesions, either as an osseous single-system disease with uni- or multifocal bony lesions, or as part of a multi-system disease. Since several decades, radiotherapy (RT) has been reported to be effective even with very low doses for osseous manifestations of LCH either as a single or combined (e.g., bisphosphonates, chemotherapy) treatment. The target cells and mechanisms of ionizing radiation remain unclear. An internet-guided literature research for the period from 1970-2004 reveales 65 evaluable studies with 683 evaluable pt. dealing with RT of osseous LCH manifestations. In 96,3% of pt., RT led to a local control, 93,4% of those had a complete remission. Nevertheless, many questions concerning RT in osseous LCH remain open: a) does exist an RT-modulation (chemotherapy)? b) what is the ideal timing for RT? c) what are the exact indications for RT? d) is there an age-related response? and, as the most important question: e) what is the ideal RT-dose/-fractionation? A possible solution for these open questions is the implementation of a prospective RT registry, which would allow to learn more about LCH and to develop a differentiated analysis of treatment outcome in correlation to different factors. Such registry would be the base for international studies and interdisciplinary guidelines for the use of RT in bony LCH-lesions.