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Extracorporeal irradiation for malignant bone tumors.

A Hong¹, G Stevens, P Stalley

¹Department of Radiation Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. ahong@radonc.rpa.cs.nsw.gov.au

International Journal of Radiation Oncology, Biology, Physics

|May 31, 2001

Summary

Extracorporeal irradiation (ECI) offers promising short-term oncologic and orthopedic outcomes for primary malignant bone tumors. This limb-sparing technique shows good functional results in selected patients.

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Area of Science:

Orthopedic Oncology
Surgical Oncology
Radiation Oncology

Background:

Extracorporeal irradiation (ECI) is a selective technique for managing primary malignant bone tumors.
Since 1996, ECI has been employed, necessitating reporting of its techniques and outcomes.

Observation:

Sixteen patients with primary malignant bone tumors (Ewing's sarcoma, osteosarcoma, chondrosarcoma) underwent ECI between 1996 and 2000.
Tumor-bearing bone was resected after induction chemotherapy, irradiated extracorporeally (50 Gy), and reimplanted.
Irradiation utilized either a linear accelerator or a blood product irradiator.

Findings:

At a median follow-up of 19.5 months, no local recurrences or graft failures were observed.
One patient required amputation due to chronic osteomyelitis.
Functional outcomes were graded as good to excellent in 10 patients with over 18 months of follow-up.

Implications:

ECI demonstrates encouraging short-term oncologic and orthopedic results for limb-sparing surgery in select patients.
This technique is a viable alternative for reconstruction in primary malignant bone tumors.
Long-term outcomes require careful assessment within a multidisciplinary setting.