Long-term effects of radiotherapy in situ for limb salvage in patients with osteosarcoma

SONG Jian-min; LI Jing

doi:10.3969/j.issn.2095-252X.2018.01.008

Abstract：Objective Limb salvage surgery is a main treatment method for limb osteosarcom. There are many ways to choose tumor inactivation in situ. Intraoperative electron beam radiotherapy is a simple way with less postoperative complications. We evaluated the clinical effects of this approach by analyzing 3 cases of limb osteosarcom. Methods The data of 3 cases from May 2003 to April 2006 were selected. The general information, operation approach, mode and dose of intraoperative electron beam irradiation, postoperative recovery and postoperative limb functions were compared. Results of limb salvage surgery ( electron beam irradiation, tumor resection, internal fixation ) were evaluated. Results One patient died of lung metastasis 8 months after the surgery. One patient had plate fracture 5 months postoperatively and underwent second operation, who was tumor-free and followed up for 12 years. One patient underwent second surgery 5 years postoperatively due to the post-operative osteonecrosis, who was tumor-free and followed up for 12 years. Advantages of intraoperative radiotherapy: local inactivation, preserved normal articulation, less invasive, faster rehabilitation, simplified approach. Disadvantages:high costs of equipment and long operation time. Conclusions Intraoperative radiotherapy can inactivate tumor tissues in situ, without immediate reduction of biological properties of the tumor bone. Postoperative limb and joint functions are not easily affected. Therefore, intraoperative radiotherapy is suitable for biological limb salvage in the treatment of osteosarcoma.