Comparative study or the effect of extracorporeal irradiation of tumor segment and alcohol inactivation during limb salvage surgery for malignant bone tumors

Abstract

Objective To compare and analyze the effects of intraoperative extracorporeal irradiation (IEI) and alcohol inactivation (AI) in the surgery of limb salvage in malignant bone tumors, and to provide references for clinical selection of safer and more effective methods of tumor segment bone inactivation. Methods The clinical data of 54 patients with malignant bone tumors who received IEI or AI bone replantation in the surgery of malignant bone tumors at the Affiliated Cancer Hospital of Zhengzhou University from January 2008 to January 2016 without tumor metastasis were retrospectively analyzed. Among the 54 patients, there were 27 males and 27 females, aged 7-58 (20.58±12.89) years. According to the method of bone inactivation and replantation, the patients were divided into the irradiation group (25 patients) and the alcohol group (29 patients). The differences of tumor recurrence, bone healing rate, bone healing time, bone nonunion rate, fracture rate, infection rate and bone absorption rate were compared between the two groups. Results Twenty-five cases were treated with IEI, the average follow-up was 20.48±6.39 months. One patient had local recurrence (4%). Bone healing occurred in 16 patients (64.00%), with an average of (8.75±2.38) months of bone healing time. There were infections in 2 patients (8%). The mean follow-up time of 29 patients receiving AI replantation was (41.79±24.74) months, 5 patients (17.24%) relapsed, 13 patients (44.83%) healed, the mean bone healing time was (25.31±13.62) months, and 2 patients (6.4%) were infected. The healing time of inactivated bone was significantly different between the two groups (P 0.05). Conclusions Both methods were effective. Irradiation inactivation method is superior to alcohol inactivation method in safety and the mean healing time of inactivated bone. However, irradiation inactivation requires professional equipment and limits its application. Key words: Bone neoplasms; Irradiation inactivated; Ethanol; Inactivated replantation; Limb salvage; Postoperative complications