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Seventy patients with osteogenic sarcoma have been treated by irradiation. Of these, 64 are dead. Of the 6 patients known to be alive, 4 have fibrosarcomas; one a sarcoma developing on an old osteitis fibrosa cystica. The remaining case is by radiographic appearance a sclerosing osteogenic sarcoma, but it lacks histologic confirmation. Of the 6 patients, only one has survived more than five years. At present we feel that irradiation should be offered in preference to amputation only:
- 1.1. When of doubtful operability.
- 2.2. When the histologic picture suggests definite radiosensitivity.
- 3.3. When a small periosteal lesion affords opportunity for combined external and interstitial irradiation.
- 4.4. In medullary osteogenic fibrosarcomas of low malignancy.
All inoperable cases and those in which amputation is refused should receive thorough, well-planned irradiation. If improvement is noted, it should be an indication for further use of irradiation up to limits of skin tolerance. At present we favor prolonged treatment by the fractional dose method. With few exceptions our results in the treatment of pulmonary metastases have not been encouraging.
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© 1935 Published by Elsevier Inc.