BONE TUMOURS IN UGANDA AFRICANS

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THE ROLE OF RADIOTHERAPY IN THE TREATMENT OF TUMOURS IN CHILDREN

Radiotherapy has an established place in the treatment of some tumours in children, both for cure and palliation. An evaluation of this form of treatment is made, based on experience with the children admitted to the Christie Hospital and Holt Radium Institute during the past 30 years.

SOME ASPECTS OF CALCIUM METABOLISM IN MALIGNANT DISEASE OF BONE

The rate of calcification of new bone (accretion rate) was measured by a radioisotope technique in 20 patients with carcinoma of the breast, 14 patients with multiple myelomatosis, five patients with Paget's disease of bone, and in six patients with solitary, non-osseous tumours. The rate of bone destruction was assessed in these patients by the measurement of the rate of urinary calcium excretion. In the patients with carcinoma of the breast and bone metastases there was a marked increase both in the accretion rate and in the urinary calcium excretion suggesting an osteoblastic response to bone destruction. An osteoblastic response was also present in the patients with multiple myelomatosis but was not correlated with the urinary calcium excretion. In patients with Paget's disease of bone, high values of accretion rate were found indicating very active new bone formation.

THE GROWTH OF BROWN-PEARCE CARCINOMA IN THE MEDULLARY CAVITY OF THE RABBIT FEMUR

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OSTEOGENIC SARCOMA IN CHILDREN

One hundred and thirty children less than 16 years of age with pathologically verified osteogenic (skeletogenic) sarcoma were seen during a 30-year period (1925-1955) with a minimum follow-up of ten years. This age group represents 23.6 per cent of the authors' total experience with skeletogenic sarcoma. The absolute survival for the entire series was 18.5 per cent at five years and 16.2 per cent at ten years. No child with an osseous tumor elsewhere than in an extremity had longterm survival. Amputation was the only "curative" method of therapy; 23 per cent of patients so treated were alive at five years and 20 per cent were alive at ten years. Radiation was never "curative" when used as the sole method of therapy, and treatment failure was higher in the group of patients who were treated with preoperative irradiation and then amputation than in the group treated by amputation alone. Prognosis varied with the size of the tumor-the smaller the better. The most important factor in prognosis was the histologic subgrouping of osteogenic sarcoma. No evidence was found to support a belief that there are considerable differences between skeletogenic sarcomas in children and in adults.