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.
University Muscoloskeletal Oncology Unit, Mt. Sinai Hospital, Toronto, Ontario, Canada.
R S
RS
Bell
B
B
O'Sullivan
C
C
Nguyen
J
J
Mahoney
F
F
Langer
B
B
Cummings
A
A
Czitrom
C
C
Catton
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