[Radiotherapy of bone tumors. Analysis of a historic series and review of the literature].

The authors report a series of patients with osteosarcoma or Ewing's sarcoma irradiated 1968-1988 at the Institute of Radiology of "La Sapienza" University, Rome. Twelve of 17 osteosarcoma patients (71%) died and 5 are alive, with a median survival of 13 months. Seven of 12 Ewing's sarcoma patients (58%) died and 5 are alive (42%), with a median survival of 67 months. These results are similar to those of most contemporary series in the literature; the long follow-up of our series allowed us to calculate actuarial survival rates at 5, 10 and 15 years of 41%, 34% and 17%, respectively, in osteosarcoma patients and 75%, 45% and 34% for those with Ewing's sarcoma. The review of the literature on the management of bone tumors high-lights the importance of new developments and technologies to improve the life expectancy of these patients. The authors discuss the role of modern imaging techniques in defining tumor margins and predicting treatment-induced tumor regression and the research into new therapeutic approaches. Multimodality combinations and new schedules appear promising tools to improve prognosis and to reduce side-effects, thus stressing the need of combined efforts of surgeons, radiotherapists and chemotherapists. State-of-the-art radiotherapy can further increase local control with higher total doses to the lesion and selectively sparing adjacent normal tissues, thanks to 3D treatment planning of hadron beam equipment.