Intraoperative extracorporeal irradiation and re-implantation of involved bone for the treatment of musculoskeletal tumors

J Exp Clin Cancer Res. 2007 Dec;26(4):571-4.

Abstract

The purpose of this trial is to evaluate the results of musculoskeletal tumors which is treated with limb salvage surgery and extracorporeal radiotherapy. Patients were treated with en-bloc resection followed by 50 Gy single dose extracorporeal irradiation and re-implantation of involved bone segments. Nine of fifteen were female and 6 were male, median age was 19. Tumor originated from tibia in 7 patients, femur in 3, humerus in 3, calcaneus in 1 and scapula in 1. Preoperative chemotherapy was given to 12 patients, 3 of them had not been treated previously. Median follow-up time of the survivors was 22 months (range 2-47 months); local recurrence and lung metastases occurred in one patient (local recurrence was away from the re-implanted bone segment), and lung metastases were reported in another 3 patients. Wound healing problems occurred in 4 patients and delayed union in 2 patients. Amputation was performed in 2 patients due to uncontrolled infection, and infected bone was replaced by a fibula graft in another patient. Treatment was successful in 12 patients where functional results were good in 9, excellent in 2 and not evaluated in 1. Limb salvage using en-bloc resection followed by intraoperative extracorporeal irradiation and re-implantation of involved bone is a useful and cheap reconstruction method in appropriately selected patients.

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / surgery*
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / surgery*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Replantation*
  • Sarcoma / radiotherapy
  • Sarcoma / surgery