PURPOSE: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb. METHODS AND MATERIALS: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months. RESULTS: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4-29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays. CONCLUSIONS: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved.
PURPOSE: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb. METHODS AND MATERIALS: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months. RESULTS: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4-29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays. CONCLUSIONS: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved.
Authors: Claudia Blattmann; Susanne Oertel; Daniela Schulz-Ertner; Stefan Rieken; Sabine Haufe; Volker Ewerbeck; Andreas Unterberg; Irini Karapanagiotou-Schenkel; Stephanie E Combs; Anna Nikoghosyan; Marc Bischof; Oliver Jäkel; Peter Huber; Andreas E Kulozik; Jürgen Debus Journal: BMC Cancer Date: 2010-03-12 Impact factor: 4.430
Authors: Sridhar Vijayan; William Bartlett; Robert Lee; Peter Ostler; Gordon W Blunn; Stephen R Cannon; Timothy Wr Briggs Journal: Indian J Orthop Date: 2011-03 Impact factor: 1.251
Authors: Rose Eli Grassi Rici; Dayane Alcântara; Paula Fratini; Cristiane Valverde Wenceslau; Carlos Eduardo Ambrósio; Maria Angelica Miglino; Durvanei Augusto Maria Journal: BMC Vet Res Date: 2012-02-22 Impact factor: 2.741