Extracorporeal Irradiation and Reimplantation of Tumor-bearing Bone Segments Following Diaphyseal Sarcoma Resection at the Tibia

Anticancer Res. 2019 Apr;39(4):2015-2023. doi: 10.21873/anticanres.13312.

Abstract

Background/aim: Reconstruction of diaphyseal tibial sarcomas with extracorporeal irradiated autograft is a rarely applied technique and is analyzed in this study.

Patients and methods: Eight patients with malignant sarcomas received local treatment by means of a wide resection and reimplantation of an extracorporeally-irradiated autograft. The graft was combined with an ipsilateral vascularized fibula when a full-thickness segment of the tibia had to be resected and no cortex could be preserved (n=5). Oncological and functional results were recorded.

Results: All patients had clear margins after resection, and with no local recurrence 72 months after treatment. Full weight-bearing was allowed at the time of radiological consolidation of the irradiated grafts (after a median of five months). The functional results were good and excellent in 7 of 8 patients, respectively.

Conclusion: Extracorporeal irradiation grafting is a suitable method for the treatment of localised and resectable tibial sarcomas.

Keywords: Extracorporeal irradiation; diaphyseal tibial sarcomas; extracorporeally irradiated autograft; reimplantation; tumor-bearing bone segments.

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms* / radiotherapy
  • Bone Neoplasms* / surgery
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Replantation*
  • Sarcoma* / radiotherapy
  • Sarcoma* / surgery
  • Soft Tissue Neoplasms* / radiotherapy
  • Soft Tissue Neoplasms* / surgery
  • Tibia / surgery*
  • Young Adult