Long-term control of multiple lung metastases from osteosarcoma obtained by conventional radiotherapy: a case report

An osteosarcoma patient whose lung metastases were successfully treated with radiotherapy is reported. The patient developed multiple lung metastases repeatedly after successful treatment of the primary lesion in his femur. Resection of the lung metastases was performed 5 times during 4 years (12 metastatic nodules in total). One of the specimens was evaluated using the micronucleus test, which suggested moderate radiosensitivity of the tumor. He further developed 2 metastases 19 months after the last operation, and these tumors were treated with conventional radiation with 60 and 64 Gy, respectively. The tumors regressed slowly after radiation and disappeared later. Although he developed another lung metastasis 2 years later, the lesion was also treated with radiation with 66 Gy and all of the 3 irradiated tumors are now under control at 43 months after the first radiotherapy and 15 months after the second one. Our experience would suggest that some (at least) metastatic osteosarcomas have reasonable radiosensitivity, and radiation therapy including radiosurgery may be a good alternative to surgery in patients for whom operation is not indicated.