

ORIGINAL ARTICLE Year : 2013 | Volume : 50 | Issue : 4 | Page : 306-309

Role of extracorporeal irradiation in malignant bone tumors



DN Sharma1, S Rastogi2, S Bakhshi3, GK Rath1, PK Julka1, MA Laviraj1, SA Khan2, A Kumar2

1 Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India

2 Department of Orthopedic Surgery, All India Institute of Medical Sciences, New Delhi, India

3 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India





Date of Web Publication 24-Dec-2013

Correspondence Address:

D N Sharma

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi

India

Source of Support: None, Conflict of Interest: None Check 4

DOI: 10.4103/0019-509X.123601



» Abstract

Aims and Objectives: Extracorporeal irradiation (ECI) is relatively a rare method used in the management of malignant bone tumors (MBT). It consists of en-bloc removal of the tumor bearing bone segment, removal of the tumor from the bone, irradiation, and re-implantation back in the body. We report our preliminary experience of using ECI for management of MBT. Materials and Methods: From year 2009 to 2010, 14 patients with primary MBT were enrolled into this study. The eligibility criteria included histopathological proof of malignancy, no evidence of distant metastases, and suitability for limb preservation therapy. Surgery was performed about 4 weeks after completion of neoadjuvant chemotherapy. The affected bone segment was resected, irradiated extracorporeally with a dose of 50 Gy and reimplanted. Local control, complications and short-term survival were studied. Functional outcome was assessed by Musculoskeletal Tumor Society (MSTS) scoring system. Results: There were 10 males and four females with median age of 14 years. Histopthologically, nine patients had osteosarcoma (OS) and five had Ewing's sarcoma family of tumors (ESFT). Distribution of primary site was as follows: Femur eight patients, tibia five patients and humerus one patient. At a median follow-up was 22 months, three patients (two OS, one ESFT) had local recurrence. Two patients (14%) developed wound infection in the perioperative period. The 2 year local recurrence free survival was 73% and mean MSTS score was 88. Conclusion: Results of our study suggest that ECI is technically feasible in the management of MBT and provides decent local control and short-term survival rates.

Keywords: Extracorporeal irradiation, limb preservation, malignant bone tumors

How to cite this article:

Sharma D N, Rastogi S, Bakhshi S, Rath G K, Julka P K, Laviraj M A, Khan S A, Kumar A. Role of extracorporeal irradiation in malignant bone tumors. Indian J Cancer 2013;50:306-9

How to cite this URL:

Sharma D N, Rastogi S, Bakhshi S, Rath G K, Julka P K, Laviraj M A, Khan S A, Kumar A. Role of extracorporeal irradiation in malignant bone tumors. Indian J Cancer [serial online] 2013 [cited 2020 Sep 19];50:306-9. Available from: http://www.indianjcancer.com/text.asp?2013/50/4/306/123601

» Introduction

» Materials and Methods

Figure 1: Radiological images and operative photographs of a 10 year old boy diagnosed with osteosarcoma of lower end of right femur that underwent extracorporeal irradiation (ECI). (a) (plain radiograph) and (b) (reconstructed computed tomography scan) showing the tumor at the lower end of femur. (c) the resected bone segment from which the tumor has been removed. The same was packaged and sent for ECI. (d) the operated limb after the resection of the bone segment



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» Results

Table 1: Details of the patients with their demography, clinical, treatment and outcome characteristics



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Figure 2: The Kaplan Meier curve showing local recurrence free survival of all the patients



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» Discussion

» References

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