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| 2) The four criteria are (1) a history of primary radiation for a benign process or a malignancy without osteoblastic activity, (2) the presence of a bony sarcoma arising within the path of the radiation beam, (3) a long asymptomatic period, and (4) the presence of histologically proven osteosarcoma. If the tumor is deemed unresectable or if resection imposes unacceptable morbidity, primary radiation therapy may be considered as a palliative measure. Although the number of patients we evaluated is too small for meaningful survival analysis, the fact that only 1 of the 5 patients who had stage II disease or less and who had been treated with primary radiation therapy died of their disease within 5 years suggests that irradiation may be a viable treatment option in early-stage disease. |
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