Patient-Specific High-Dose Single-Fraction Extracorporeal Irradiation in Osteosarcoma: Technique and Clinical Outcome

Osteosarcoma is a rare malignant bone tumor that is difficult to manage with traditional methods. The technique of delivering single fraction high-dose radiation directly to the bone, extracorporeal irradiation (ECI), minimizes radiation-induced damage to adjacent healthy tissues. Planning the ECI technique as patient-specific as possible and mimicking the real radiotherapy process will increase the potential advantages. In this case report, we aimed to present our patient-specific designed ECI technique managed by a multidisciplinary team of orthopedics and traumatology and radiation oncology clinics and 6 years follow-up data. As a limb preservation therapy approach, a 14-year-old female patient diagnosed with osteosarcoma underwent en-block resection, ECI with a total prescribed radiation dose of 75 Gray and reimplantation of the left femur bone. Our case results revealed that patient-specific ECI is fully effective on 6 years of local recurrence control and disease-free survival, with no postoperative complications and concomitant preservation of limb functionality.