Tsuboyama T, Toguchida J, Kotoura Y, Kasahara K, Hiraoka M, Nakamura T
Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
Int Orthop. 2000;24(4):202-7. doi: 10.1007/s002640000154.
The outcome following intra-operative radiation therapy in the treatment of osteosarcoma in the extremity in 33 patients was evaluated for oncological and functional results. Local recurrence occurred in seven cases, six of which were in a non-irradiated region, indicating inappropriate planning of the radiation field. Twenty-one patients underwent either prosthetic replacement (14) or amputation (7). Irradiated tumours were left in situ in the remaining 12 patients. In this latter group no degenerative joint changes were observed radiologically. Twenty-six patients experienced local complications, of which fracture of the irradiated bone was the most significant. Associated intramedullary nailing showed encouraging results in preventing fracture. Although IORT is effective for the local control of osteosarcoma in extremities, critical patient selection and improvements of treatment protocol are required in order to obtain a satisfactory outcome.
对33例肢体骨肉瘤患者术中放疗后的结果进行了评估，以观察肿瘤学和功能结果。7例出现局部复发，其中6例发生在未照射区域，表明放疗野规划不当。21例患者接受了假体置换（14例）或截肢（7例）。其余12例患者的照射肿瘤留在原位。在后一组中，影像学上未观察到退行性关节改变。26例患者出现局部并发症，其中照射骨骨折最为严重。联合髓内钉固定在预防骨折方面显示出令人鼓舞的结果。虽然术中放疗对肢体骨肉瘤的局部控制有效，但为了获得满意的结果，需要严格筛选患者并改进治疗方案。
