gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Radiotherapy of bone tumours

Meeting Abstract

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27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocIS090

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk090.shtml

Veröffentlicht: 20. März 2006

© 2006 Schuck.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Polychemotherapy and local therapy are the main treatment components in both Ewing tumours and osteosarcomas. In Ewing tumours, local control rates are best when complete surgical resection is possible. The local failure rate in operable patients is < 10 %. Combined surgery and radiotherapy is indicated in patients with marginal or intralesional resections or when there is poor histological response to chemotherapy. Debulking procedures do not improve local control and radiotherapy should be given instead. Definitive radiotherapy is curative but the local failure rate is above 20 %. The target volume for radiotherapy is usually the initial tumour extent + a 2 cm margin. The doses range between 45 and 55 Gy depending on response and extent of resection. Osteosarcoma is usually considered as a radioresistant tumor. The main local treatment modality is a wide tumour resection and radiotherapy is limited to situations where resection is incomplete or not possible at all. In a recent analysis of osteosarcoma patients refusing surgery but receiving systemic therapy and local irradiation, local progression-free survival at 5 years was 56 %. Survival was about 90 % after 5 years in the subgroup of irradiated patients responding to chemotherapy. Therefore, although surgery is the local treatment of choice, cure can also achieved with radiation in inoperable tumors or patients refusing surgery and radiotherapy is indicated following incomplete resection. High doses if possible above 60 Gy should be given.