Fractures following limb-salvage surgery and adjuvant irradiation for soft-tissue sarcoma.
In a prospective study, consecutive patients were treated for soft-tissue sarcoma (STS) by wide resection and adjuvant irradiation. Twelve patients had resection of bone to achieve a tumor free margin; five of these patients were left with lower extremity open segmental cortical defects in the high-dose radiation field. Four of the five patients with cortical defects suffered a fracture through the defect more than six months after surgery. Only one of 71 patients not treated with bony resection suffered a late fracture. Patients requiring bony cortex resection for STS of the lower extremity should be considered at risk for late fracture if adjuvant irradiation is prescribed.
Bell
R S
RS
University Muscoloskeletal Oncology Unit, Mt. Sinai Hospital, Toronto, Ontario, Canada.
O'Sullivan
B
B
Nguyen
C
C
Mahoney
J
J
Langer
F
F
Cummings
B
B
Czitrom
A
A
Catton
C
C
D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000528:radiation effects* / Q000601:surgery; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D005264:Femoral Fractures / Q000209:etiology; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008297:Male; D010329:Patella / Q000293:injuries; D010388:Pelvis / Q000293:injuries; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology*; D016879:Salvage Therapy; D012509:Sarcoma / Q000532:radiotherapy* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D013977:Tibia / Q000293:injuries