Bone metastasis leading to pathologic fracture or a substantial source of mobility among patients with advanced cancer.
Prophylactic surgical stabilization followed by postoperative radiotherapy is the Standard Of Care for impending pathologic fractures.
Surgical fixation provides immediate skeletal stability, radiation therapies is intended to provide to control and paying palliation.
Failure of tumor control can threaten the fixation of surgical implants and the durability of elation and functional outcomes.
Expansion of the postoperative radiation field to include the entire surgical hardware is associated with the lower rate local tumor recurrence.
Disadvantage include need for surgical dissection to introduce fixation device, insertion of a foreign body, necessity of elimination of bacterial contamination in open fractures and the development of osteoporosis.
Preoperative stereotactic body radiotherapy is associated with a low risk of wound complications and durable local tumor control.