title: Intraoperative extracorporeal irradiation and re-implantation of involved bone for the treatment of musculoskeletal tumors.
abstract: The purpose of this trial is to evaluate the results of musculoskeletal tumors which is treated with limb salvage surgery and extracorporeal radiotherapy. Patients were treated with en-bloc resection followed by 50 Gy single dose extracorporeal irradiation and re-implantation of involved bone segments. Nine of fifteen were female and 6 were male, median age was 19. Tumor originated from tibia in 7 patients, femur in 3, humerus in 3, calcaneus in 1 and scapula in 1. Preoperative chemotherapy was given to 12 patients, 3 of them had not been treated previously. Median follow-up time of the survivors was 22 months (range 2-47 months); local recurrence and lung metastases occurred in one patient (local recurrence was away from the re-implanted bone segment), and lung metastases were reported in another 3 patients. Wound healing problems occurred in 4 patients and delayed union in 2 patients. Amputation was performed in 2 patients due to uncontrolled infection, and infected bone was replaced by a fibula graft in another patient. Treatment was successful in 12 patients where functional results were good in 9, excellent in 2 and not evaluated in 1. Limb salvage using en-bloc resection followed by intraoperative extracorporeal irradiation and re-implantation of involved bone is a useful and cheap reconstruction method in appropriately selected patients.
authors: Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey.
authors: Y
authors: Y
authors: Anacak
authors: D
authors: D
authors: Sabah
authors: S
authors: S
authors: Demirci
authors: S
authors: S
authors: Kamer
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012092:Replantation; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery