Fifteen year radiotherapy experience with chondrosarcoma of bone

A retrospective analysis of 20 patients with chondrosarcoma of bone treated for cure between 1961 and 1976 using supervoltage radiotherapy and/or neutrons is presented. Radiotherapy was used alone or in combination with other modalities. The 20 patients were divided into four groups: 1) 11 patients who received radiotherapy alone, 2) three patients who received postoperative radiotherapy following less than radical local excision, 3) three patients who received radiotherapy with chemotherapy but without surgery, and 4) three patients who received radiotherapy for tumor recurrent after surgery. Typical tumor doses ranged from 4000 to 7000 rad at 1000 rad/week using parallel-opposed fields. Failure of radiotherapy was indicated by progression of symptoms and increasing tumor size. At 53 months, the average follow-up, the survival rate is 65% (13/20), including one patient with distant metastases, and two patients who developed local recurrent disease after radiotherapy and were surgically salvaged. Seven patients died with uncontrolled local disease; six of them also had distant metastases. Five patients developed severe complications. All four patients treated with a combination of neutron and photon beam alone show no evidence of local failure, compared with only one of the seven patients treated with conventional radiotherapy alone.