protocol

Chemotherapy

Sensitivity

 

High grade tumours often sensitive to intensive chemotherapy

- OS

- Ewings

- MFH

 

Low grade often insensitive 

- Chondrosarcoma

- Parosteal OS 

 

Role

 

1.  Eradication of overt & micrometastasis

- OS 80% have micrometastasis

 

2.  Reduce tumour locally 

- makes limb salvage easier

 

Bone scans

Definition

 

Technetium 99m labelled MDP (Mono - diphosphonate)

 

Advantages

 

1.  Pure gamma emitter

 

2.  Half life only 6 hours

- limits radiation exposure

 

3.  Localises in bone

- chemical interaction on the surface of the hydroxyapatite crystal of bone

- phosphorous component interacts with the endogenous calcium

- produces insoluble technetium calcium phosphate complexes.

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