Radical intraoperative thermal ablation of osteogenic sarcoma: clinical observation

Abstract

Introduction. Difficult diagnosis, aggressive progression, and absence of an increase in treatment effectiveness (especially in patients with osteosarcoma and Ewing sarcoma) make malignant tumors of the bones a significant medical problem. Use of traditional therapy methods is often associated with development of drug resistance and frequent recurrences. Therefore, there is a need for new treatment strategies and overcoming of the limitations of traditional methods through their improvement, combination or substitution to achieve higher survival, lower recurrence rate, and wider availability for patients with bone tumors.Aim. To present a clinical observation of the use of a new method of radical intraoperative thermal ablation for bone tumors, assess exposure tolerance, long-term oncological and functional results.Clinical observation. This article presents a clinical case of the use of a new radical treatment method for a patient with tibial osteosarcoma who underwent intraoperative thermal ablation using a new domestic complex of local hyperthermia “Phoenix-2”.Results. A session of intraoperative thermal ablation was performed in the operating room under anesthesia directly in the wound for 48 minutes. Access to the tumor-affected bone was performed with the standard oncological approach (en-block), the bone was not transected or removed. A constant heating mode of 90 °С was used, assuming a gradual increase in temperature. Thus, 60 °С reached 20 minutes, and the temperature at the end of high-temperature exposure was 78 °С (inside the medullary canal). The operation time was 2 hours 30 minutes. The postoperative period proceeded without complications. After 38 months of follow-up, examinations did not reveal any recurrence or progression in the patient.Conclusion. The technique of radical intraoperative thermal ablation using a local hyperthermia complex Phoenix-2 is effective and allows to widen the toolkit of treatment methods for patients with bone tumors. It can serve as an alternative or addition to organ-preserving surgical treatment without costly reconstruction stages.