Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities
Purpose : To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb. Methods and Materials : Thirty-nine patients with osteosarcoma in their extremities were trea...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2001-09, Vol.51 (1), p.87-93 |
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| creator | Oya, Natsuo Kokubo, Masaki Mizowaki, Takashi Shibamoto, Yuta Nagata, Yasushi Sasai, Keisuke Nishimura, Yasumasa Tsuboyama, Tadao Toguchida, Junya Nakamura, Takashi Hiraoka, Masahiro |
| description | Purpose
: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb.
Methods and Materials
: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months.
Results
: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4–29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays.
Conclusions
: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved. |
| doi_str_mv | 10.1016/S0360-3016(01)01603-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_18228881</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301601016030</els_id><sourcerecordid>18228881</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-b214cbc16aa81328a0e7d90cf428449693ce765212e55c2ebb9af374f7047bdf3</originalsourceid><addsrcrecordid>eNqFkE1LJDEQhoMoOjv6E5Q-iKyH1lTSH-nTsrjrBwgeVPAW0umKE-nujEnP4PjrzXyg3jxVFXnqrfAQcgj0DCgU5_eUFzTlsf1N4TQWylO6RUYgyirlef60TUafyB75FcILpRSgzHbJHkAOhciLEdH_0NjeDnaOie0Hr9wUvVqNc_SLZGKfJ2njAiZeNdYNk_g6XSTG-aR1WrX2HZvEhQFdUF67TsWUJFIJvg0euxiMYZ_sGNUGPNjUMXm8_P9wcZ3e3l3dXPy9TXUmqiGtGWS61lAoJYAzoSiWTUW1yZjIsqqouMayyBkwzHPNsK4rZXiZmZJmZd0YPiYn69ypd68zDIPsbNDYtqpHNwsSBGNCxOwxydeg9i4Ej0ZOve2UX0igcmlXruzKpTpJQa7sShr3jjYHZnWHzdfWRmcEjjeAClGO8arXNnzjOLBqef_PGsNoY27Ry6At9hob61EPsnH2h598AKgPmBc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>18228881</pqid></control><display><type>article</type><title>Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Oya, Natsuo ; Kokubo, Masaki ; Mizowaki, Takashi ; Shibamoto, Yuta ; Nagata, Yasushi ; Sasai, Keisuke ; Nishimura, Yasumasa ; Tsuboyama, Tadao ; Toguchida, Junya ; Nakamura, Takashi ; Hiraoka, Masahiro</creator><creatorcontrib>Oya, Natsuo ; Kokubo, Masaki ; Mizowaki, Takashi ; Shibamoto, Yuta ; Nagata, Yasushi ; Sasai, Keisuke ; Nishimura, Yasumasa ; Tsuboyama, Tadao ; Toguchida, Junya ; Nakamura, Takashi ; Hiraoka, Masahiro</creatorcontrib><description>Purpose
: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb.
Methods and Materials
: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months.
Results
: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4–29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays.
Conclusions
: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/S0360-3016(01)01603-0</identifier><identifier>PMID: 11516856</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Adverse effect ; Biological and medical sciences ; Bone Neoplasms - mortality ; Bone Neoplasms - pathology ; Bone Neoplasms - radiotherapy ; Child ; Combined Modality Therapy ; Diseases of the osteoarticular system ; Diseases of the osteoarticular system. Orthopedic treatment ; Extremities ; Female ; Femoral Neoplasms - mortality ; Femoral Neoplasms - pathology ; Femoral Neoplasms - radiotherapy ; Humans ; Humerus ; Ilium ; Intraoperative Period ; IORT ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local ; Osteosarcoma ; Osteosarcoma - mortality ; Osteosarcoma - pathology ; Osteosarcoma - radiotherapy ; Outcome ; Radiotherapy Dosage ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Tibia ; Treatment Outcome ; Tumors of striated muscle and skeleton</subject><ispartof>International journal of radiation oncology, biology, physics, 2001-09, Vol.51 (1), p.87-93</ispartof><rights>2001 Elsevier Science Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-b214cbc16aa81328a0e7d90cf428449693ce765212e55c2ebb9af374f7047bdf3</citedby><cites>FETCH-LOGICAL-c489t-b214cbc16aa81328a0e7d90cf428449693ce765212e55c2ebb9af374f7047bdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301601016030$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1131291$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11516856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oya, Natsuo</creatorcontrib><creatorcontrib>Kokubo, Masaki</creatorcontrib><creatorcontrib>Mizowaki, Takashi</creatorcontrib><creatorcontrib>Shibamoto, Yuta</creatorcontrib><creatorcontrib>Nagata, Yasushi</creatorcontrib><creatorcontrib>Sasai, Keisuke</creatorcontrib><creatorcontrib>Nishimura, Yasumasa</creatorcontrib><creatorcontrib>Tsuboyama, Tadao</creatorcontrib><creatorcontrib>Toguchida, Junya</creatorcontrib><creatorcontrib>Nakamura, Takashi</creatorcontrib><creatorcontrib>Hiraoka, Masahiro</creatorcontrib><title>Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose
: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb.
Methods and Materials
: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months.
Results
: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4–29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays.
Conclusions
: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adverse effect</subject><subject>Biological and medical sciences</subject><subject>Bone Neoplasms - mortality</subject><subject>Bone Neoplasms - pathology</subject><subject>Bone Neoplasms - radiotherapy</subject><subject>Child</subject><subject>Combined Modality Therapy</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the osteoarticular system. Orthopedic treatment</subject><subject>Extremities</subject><subject>Female</subject><subject>Femoral Neoplasms - mortality</subject><subject>Femoral Neoplasms - pathology</subject><subject>Femoral Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>Humerus</subject><subject>Ilium</subject><subject>Intraoperative Period</subject><subject>IORT</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Osteosarcoma</subject><subject>Osteosarcoma - mortality</subject><subject>Osteosarcoma - pathology</subject><subject>Osteosarcoma - radiotherapy</subject><subject>Outcome</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Tibia</subject><subject>Treatment Outcome</subject><subject>Tumors of striated muscle and skeleton</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LJDEQhoMoOjv6E5Q-iKyH1lTSH-nTsrjrBwgeVPAW0umKE-nujEnP4PjrzXyg3jxVFXnqrfAQcgj0DCgU5_eUFzTlsf1N4TQWylO6RUYgyirlef60TUafyB75FcILpRSgzHbJHkAOhciLEdH_0NjeDnaOie0Hr9wUvVqNc_SLZGKfJ2njAiZeNdYNk_g6XSTG-aR1WrX2HZvEhQFdUF67TsWUJFIJvg0euxiMYZ_sGNUGPNjUMXm8_P9wcZ3e3l3dXPy9TXUmqiGtGWS61lAoJYAzoSiWTUW1yZjIsqqouMayyBkwzHPNsK4rZXiZmZJmZd0YPiYn69ypd68zDIPsbNDYtqpHNwsSBGNCxOwxydeg9i4Ej0ZOve2UX0igcmlXruzKpTpJQa7sShr3jjYHZnWHzdfWRmcEjjeAClGO8arXNnzjOLBqef_PGsNoY27Ry6At9hob61EPsnH2h598AKgPmBc</recordid><startdate>20010901</startdate><enddate>20010901</enddate><creator>Oya, Natsuo</creator><creator>Kokubo, Masaki</creator><creator>Mizowaki, Takashi</creator><creator>Shibamoto, Yuta</creator><creator>Nagata, Yasushi</creator><creator>Sasai, Keisuke</creator><creator>Nishimura, Yasumasa</creator><creator>Tsuboyama, Tadao</creator><creator>Toguchida, Junya</creator><creator>Nakamura, Takashi</creator><creator>Hiraoka, Masahiro</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>20010901</creationdate><title>Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities</title><author>Oya, Natsuo ; Kokubo, Masaki ; Mizowaki, Takashi ; Shibamoto, Yuta ; Nagata, Yasushi ; Sasai, Keisuke ; Nishimura, Yasumasa ; Tsuboyama, Tadao ; Toguchida, Junya ; Nakamura, Takashi ; Hiraoka, Masahiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-b214cbc16aa81328a0e7d90cf428449693ce765212e55c2ebb9af374f7047bdf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adverse effect</topic><topic>Biological and medical sciences</topic><topic>Bone Neoplasms - mortality</topic><topic>Bone Neoplasms - pathology</topic><topic>Bone Neoplasms - radiotherapy</topic><topic>Child</topic><topic>Combined Modality Therapy</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the osteoarticular system. Orthopedic treatment</topic><topic>Extremities</topic><topic>Female</topic><topic>Femoral Neoplasms - mortality</topic><topic>Femoral Neoplasms - pathology</topic><topic>Femoral Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>Humerus</topic><topic>Ilium</topic><topic>Intraoperative Period</topic><topic>IORT</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Osteosarcoma</topic><topic>Osteosarcoma - mortality</topic><topic>Osteosarcoma - pathology</topic><topic>Osteosarcoma - radiotherapy</topic><topic>Outcome</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Tibia</topic><topic>Treatment Outcome</topic><topic>Tumors of striated muscle and skeleton</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oya, Natsuo</creatorcontrib><creatorcontrib>Kokubo, Masaki</creatorcontrib><creatorcontrib>Mizowaki, Takashi</creatorcontrib><creatorcontrib>Shibamoto, Yuta</creatorcontrib><creatorcontrib>Nagata, Yasushi</creatorcontrib><creatorcontrib>Sasai, Keisuke</creatorcontrib><creatorcontrib>Nishimura, Yasumasa</creatorcontrib><creatorcontrib>Tsuboyama, Tadao</creatorcontrib><creatorcontrib>Toguchida, Junya</creatorcontrib><creatorcontrib>Nakamura, Takashi</creatorcontrib><creatorcontrib>Hiraoka, Masahiro</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oya, Natsuo</au><au>Kokubo, Masaki</au><au>Mizowaki, Takashi</au><au>Shibamoto, Yuta</au><au>Nagata, Yasushi</au><au>Sasai, Keisuke</au><au>Nishimura, Yasumasa</au><au>Tsuboyama, Tadao</au><au>Toguchida, Junya</au><au>Nakamura, Takashi</au><au>Hiraoka, Masahiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2001-09-01</date><risdate>2001</risdate><volume>51</volume><issue>1</issue><spage>87</spage><epage>93</epage><pages>87-93</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose
: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb.
Methods and Materials
: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months.
Results
: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4–29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays.
Conclusions
: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11516856</pmid><doi>10.1016/S0360-3016(01)01603-0</doi><tpages>7</tpages></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2001-09, Vol.51 (1), p.87-93 |
| issn | 0360-3016 1879-355X |
| language | eng |
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| subjects | Adolescent Adult Adverse effect Biological and medical sciences Bone Neoplasms - mortality Bone Neoplasms - pathology Bone Neoplasms - radiotherapy Child Combined Modality Therapy Diseases of the osteoarticular system Diseases of the osteoarticular system. Orthopedic treatment Extremities Female Femoral Neoplasms - mortality Femoral Neoplasms - pathology Femoral Neoplasms - radiotherapy Humans Humerus Ilium Intraoperative Period IORT Male Medical sciences Middle Aged Neoplasm Recurrence, Local Osteosarcoma Osteosarcoma - mortality Osteosarcoma - pathology Osteosarcoma - radiotherapy Outcome Radiotherapy Dosage Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Tibia Treatment Outcome Tumors of striated muscle and skeleton |
| title | Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities |
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