Abstract
One of the most common methods for surgical treatment of bone metastasis is curettage. Local adjuvants are used to improve the effect of curettage in local cancer surgery and they may exerted their effects either chemically either physically; in orthopaedic oncology the most common are phenol, liquid nitrogen, laser, cement and argon beam coagulation. The purpose of this article is to review the main characteristics of the most common chemical and physical agents used in bone oncology, emphasizing the toxic effects of some of them, especially phenol and liquid nitrogen.
Highlights
At the beginning of the 1970s was described the first local adjuvant used in orthopaedic oncology surgery, liquid nitrogen cryotherapy, developed by Marcove at Memorial Sloan-Kettering Cancer Center of New York, and PMMA cementation, described for the first time by Persson and Wouters in 1976
Over time have been used other local adjuvants: these are both chemical, such as phenol, ethanol and hydrogen peroxide (H2O2), and physical, such as cement added with antiblastics, and above all Argon beam coagulation, based on thermo-ablation and cryosurgery with cryoprobes
Local adjuvants play an important role in surgical treatment of metastatic lesions of the skeleton
Summary
At the beginning of the 1970s was described the first local adjuvant used in orthopaedic oncology surgery, liquid nitrogen cryotherapy, developed by Marcove at Memorial Sloan-Kettering Cancer Center of New York, and PMMA cementation, described for the first time by Persson and Wouters in 1976. Over time have been used other local adjuvants: these are both chemical, such as phenol, ethanol and hydrogen peroxide (H2O2), and physical, such as cement added with antiblastics, and above all Argon beam coagulation, based on thermo-ablation and cryosurgery with cryoprobes The use of these substances is aimed at extending the results surgically obtained by curettage through the elimination of any remaining neoplastic cells. It’s important to remember that the surgical curettage remains the main treatment and any physical or chemical agent used as an adjuvant cannot correct a badly performed curettage. This is crucial to the oncological success of the surgical procedure. In this review we analyse chemical and physical aspects of the most common local adjuvant used in bone oncology
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