| Zuo Kai,Wang Wenling,Dong Hongmin,et al.Long-term efficacy observation of postoperative adjuvant radiotherapy for diffuse pigmented villonodular synovitis of the knee joint[J].Chinese Journal of Radiological Medicine and Protection,2025,45(12):1253-1258 |
| Long-term efficacy observation of postoperative adjuvant radiotherapy for diffuse pigmented villonodular synovitis of the knee joint |
| Received:March 30, 2025 |
| DOI：10.3760/cma.j.cn112271-20250330-00114 |
| KeyWords:Knee joint Pigmented villonodular synovitis (PVNS) Radiotherapy Function Safety |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zuo Kai | Department of Abdominal Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550001, China | | | Wang Wenling | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | 2275853380@qq.com | | Dong Hongmin | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Wang Gang | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Li Xiaokai | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Chen Wanghua | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Hu Yinxiang | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Jin Haijie | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | |
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| Abstract:: |
| Objective To evaluate and analyze the long-term efficacy of arthroscopic debridement combined with postoperative three-dimensional conformal radiotherapy (3 D-CRT) in the treatment of diffuse pigmented villonodular synovitis (DPVNS) of knee joints, along with the safety of joint functions.Methods A retrospective analysis was conducted on the clinical data of 60 patients with DPVNS in their knee joints who were admitted to the Affiliated Cancer Hospital of Guizhou Medical University from April 2011 to December 2023. All patients underwent arthroscopic debridement, followed by histopathological examination for definitive diagnosis. Then, these patients received postoperative adjuvant radiotherapy (POART: 30.6 or 36.0 Gy), with an average interval between the surgery and radiotherapy of (2.1 ± 0.8) months. The treatment efficacy and the functions of the affected knee joints were assessed using the validated Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, the acute and long-term adverse events were examined using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.Results The primary healing of the surgical wounds was observed in all patients, with no postoperative infection occurring. The median follow-up durations were (85.0 ± 46.7) months, and the local recurrence rate of the patients was determined at 3.3% (2 cases), with recurrence observed at 3 and 5 years post-radiotherapy. Comparisons of the affected knee joints before radiotherapy, at the end of radiotherapy, and at 1, 3, 5, and 7 years post-radiotherapy revealed no statistically significant differences in the total WOMAC score, pain, stiffness, and physical function scores (P > 0.05). This suggests that radiotherapy exerts no significant effect on the short- and long-term functions of the affected knee joints. In addition, comparisons between the two groups receiving 30.6 and 36.0 Gy POART at the end of radiotherapy and at 1, 3, 5, and 7 years post-radiotherapy also revealed no statistically significant difference (P > 0.05) in the total WOMAC scores, pain, stiffness, and physical function scores. The acute adverse events that the patients suffered were all grade-1 cutaneous adverse reactions (CARs) (7 cases, 11.67%). The subsequent long-term follow-up revealed the absence of CARs of grades ≥ 2, including local skin fibrosis, telangiectasia, soft tissue oedema, joint pain, stiffness, or restricted mobility.Conclusions Arthroscopic synovectomy combined with POART provides effective local control over DPVNS by while preserving good joint functions of patients, proving safe and reliable for the treatment of DPVNS. |
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