Application of Irradiated Bone Replants in Surgical Treatment of Osteogenic Sarcoma in Children

Ten children, aged 8-16, with osteogenic sarcoma received complex treatment which included distant gammairradiation in total focal dose of 36 Gy with chemotherapy (Pt drugs) and subsequent surgical intervention. Operation was performed 3-6 months after chemotherapy in case of stabilization of local tumor process and absence of metastases. Peculiarity of surgical tactics consisted in the following: in the operating room the resected bone with tumor (often it was the distal articular end of the femur) was subjected to single electronic bunch irradiation in 60 Gy dose and after that it was replanted. X-ray control showed that the reconstruction of irradiated replants implanted into irradiated tissues developed slowly and did not complete by the 3rd observation year. However, it did not prevent the replant from functioning as a prosthesis. In 30% of patients postoperative complications, i.e. suppuration, were noted. Four patients died. Six patients are alive, 4 out of them have follow-up period over 2 years and 2 patients — over 3 years. Authors conclude that in appropriate indications and simulataneous irradiation autobone-replants can be used for the substitution of bone defects.