Extracorporeally irradiated autografts for the treatment of bone tumours: tips and tricks.
We retrospectively reviewed 107 patients with 108 malignant or locally aggressive bone tumours treated between 1978 and 2009 by extracorporeal irradiation with 300 Gy to eradicate the tumour, and reimplantation of the bone as an orthotopic autograft. Patient subgroups were defined according to resection type. We describe the local recurrence rate, the graft infection rate and the factors affecting graft healing and graft survival. No local recurrences were detected in the irradiated grafts. At five-year follow-up, graft healing had occurred in 64% of patients, providing a stable and lasting reconstruction. For various reasons, 11% of grafts were removed, although no single factor was predictive of failure. All patient subgroups had comparable results. Early infection predicted the development of pseudarthrosis. Pelvic reconstructions had a worse graft survival. Rigid fixation and bridging of the graft appeared to be important technical points.
Poffyn
Bart
B
Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
Sys
Gwen
G
Mulliez
Alexander
A
Van Maele
Georges
G
Van Hoorebeke
Luc
L
Forsyth
Ramses
R
Uyttendaele
Dirk
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002813:Chondrosarcoma / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000532:radiotherapy / Q000601:surgery; D011878:Radiotherapy / Q000379:methods*; D012092:Replantation; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy* / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000532:radiotherapy / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult