Advanced-Technology Radiation Therapy for Bone Sarcomas

Samir Patel, MD; Thomas F. DeLaney, MD


Cancer Control. 2008;15(1):21-37. 

In This Article


High-technology intensity-modulated photon and charged-particle radiation techniques are allowing the delivery of substantially higher radiation doses than could be delivered in the past to patients with bone sarcomas while simultaneously reducing the doses to critical normal tissues. Local control has been improved with these high doses.[6,14] These techniques are particularly promising for lesions in challenging axial sites where resections are often incomplete or associated with significant morbidity. The use of protons reduces the integral dose to normal tissue, often by 2- to 3-fold; this can only reduce the risk of late radiation-associated complications.[88] Protons have been successfully combined with chemotherapy for the treatment of adult[63] and pediatric[99] sarcomas. Heavier charged particles have greater RBE because of their higher LET properties, and some interesting results are available with neon[55] and carbon ions[25,26] for bone sarcomas. Randomized comparative trials are warranted to determine if they are more effective than protons.

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