What dose and fractionation would you recommend for post-operative treatment of an isolated femur metastasis after surgical stabilization?

Interesting question.

Traditionally, in Rad Onc, post operative RT after bone stabilization has been given to patients whom the operating surgeons deemed "appropriate". Some literature suggest only 28% to 50% of post-op patients are referred for post op EBRT.

As such, because the data are so 'sketchy'...

In terms of field coverage, as a resident, I always referred to my then brand new 7th edition of DeVita's Cancer--Principles & Practice of Oncology (2005, Lippincott Williams & Wilkins), Chapter 51.4 Treatment of Metastatic Cancer (Mark W. Manoso and John H. Healey), p 2379:

"No matter what method o...

I have appreciated the comments on this thread, especially from those with many years of experience. On the question of volumes, I wonder what the added value of large margins is, outside of a possible oligometastatic setting. If the patient has numerous bone metastases, we are presumably only treat...

My approach is similar to Dan's. We considered a protocol for single fraction treatment in the postoperative setting but there were not enough patients. It is practically a good solution for some patients depending on PS.

This is a decent paper that evaluated recurrence by extent of hardware coverage...

I am unaware of any clear data to guide us on whether to treat just the area of the lesion or the entire stabilization rod.

Like a lot of things in medicine, we can be influenced by a particularly memorable case. As a resident, I had a 70ish woman, newly diagnosed with metastatic lung cancer and a l...

I agree the true value of postoperative RT is uncertain. However, the group from Brigham and Women's Hospital/Dana-Farber Cancer Institute published an analysis of their experience showing that 29% of the 17% of patients having local progression developed it marginally or out of field, but adjacent ...