Biomaterial Database

[Intraoperative radiotherapy in malignant bone tumors]. 1993

T Yamamuro, and Y Kotoura

Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.

When a bone tumor is confirmed to be malignant by biopsy and has not expanded into the soft tissue, intraoperative radiation therapy (IORT) is indicated for most parts of the four extremities. The irradiation area is exposed through an extensive skin incision, and the soft tissues are opened and retracted away from the irradiation area, leaving a layer of normal tissue directly covering the tumor. The irradiation is performed with 12-26 MeV electron beams from a betatron at a dose of 50-100 Gy, depending on the radiosensitivity of each tumor. The multifocal bilateral irradiation method is the best for minimizing complications of the soft tissues. Since 1978, we have performed IORT in combination with chemotherapy in 41 cases of malignant bone tumors and experienced only five cases of tumor recurrence one in the irradiated area and four in the non-irradiated area. Joint function in the irradiated limb was excellent. However, due to the high incidence of pathological fracture after IORT in osteolytic tumors, the limb eventually had to be replaced by a prosthesis. After 1984 when cisplatinum was introduced to our chemotherapy protocol, the cumulative 5 year survival rate increased to 81%, with the irradiated lesion preserved in situ in osteoblastic tumors and replaced with a prosthesis in osteolytic tumors.

UI	MeSH Term	Description	Entries
D007430	Intraoperative Care	Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.	Care, Intraoperative
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009364	Neoplasm Recurrence, Local	The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.	Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D011832	Radiation Injuries	Harmful effects of non-experimental exposure to ionizing or non-ionizing radiation in VERTEBRATES.	Radiation Sickness,Radiation Syndrome,Injuries, Radiation,Injury, Radiation,Radiation Injury,Radiation Sicknesses,Radiation Syndromes,Sickness, Radiation,Sicknesses, Radiation,Syndrome, Radiation,Syndromes, Radiation
D011879	Radiotherapy Dosage	The total amount of radiation absorbed by tissues as a result of radiotherapy.	Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011882	Radiotherapy, High-Energy	Radiotherapy using high-energy (megavolt or higher) ionizing radiation. Types of radiation include gamma rays, produced by a radioisotope within a teletherapy unit; x-rays, electrons, protons, alpha particles (helium ions) and heavy charged ions, produced by particle acceleration; and neutrons and pi-mesons (pions), produced as secondary particles following bombardment of a target with a primary particle.	Megavolt Radiotherapy,High-Energy Radiotherapy,Radiotherapy, Megavolt,High Energy Radiotherapy,Radiotherapy, High Energy
D001859	Bone Neoplasms	Tumors or cancer located in bone tissue or specific BONES.	Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal