[Radiation therapy and chemotherapy of primary malignant tumors of the bone (author's transl)].

In recent years, cytostatic chemotherapy has been added to the treatment of primary malignant bone tumors. Long-term results are not yet available. Since many of these tumors metastasize through the blood stream, the prognosis has been poor. Now a general improvement in the total number of cures is expected. In osteogenic sarcoma, amputation or exarticulation of the involved extremities is most frequently suggested; one can, however, continue to use preoperative radiotherapy. After 3 or at the most 6 months, amputation is carried out if the patient is free of metastases. Adjuvant chemotherapy should be carried out in every case. The side effects in the irradiated area, however, are considerably increased and, as a result, immediate amputation will become more and more popular. Irradiation of the primary tumor plays a decisive role in Ewing's sarcoma, surgical removal of the tumor does not require radicality at all costs. In reticulosarcoma of the bone, surgical intervention is limited to a biopsy because of high radiosensitivity. Adjuvant chemotherapy should be carried out in every case since a generalization is to be expected in 30% of the patients. The indications for "prophylactic" radiotherapy of the lung and the neurocranium were discussed.