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About radiotherapy

Radiotherapy uses high energy x-rays to treat cancer. Find out about radiotherapy treatment for bone cancer.

This page is about cancer that starts in your bone (primary bone cancer).

If your cancer has spread into bone from another part of the body, it is called secondary or metastatic bone cancer.

You may have a type of radiotherapy called intensity modulated radiotherapy (IMRT) to treat primary bone cancer. IMRT shapes the radiotherapy beam to fit the shape of the tumour very accurately. This allows higher doses of radiation to treat the area, while the surrounding healthy tissues get less radiation.

Why you have it

You don't routinely have radiotherapy for all types of bone cancer. But it can be an important part of treatment for Ewing's sarcoma.

You may also have radiotherapy for other types of bone cancer if your cancer has spread or come back after treatment. You sometimes have radiotherapy after surgery for chordomas. And occasionally you have it after surgery for osteosarcoma. 

Ewing's sarcoma

If you have Ewing's sarcoma, you might have radiotherapy in the following situations:

If surgery can't completely remove your cancer

It may not be possible to remove your tumour completely if the cancer is in a central area of your body. You might have a combination of surgery and radiotherapy. Or you might have radiotherapy instead of surgery. You usually have radiotherapy alongside chemotherapy.

Before or after surgery

Radiotherapy before surgery can make Ewing's sarcoma easier to remove. You might be able to have a smaller operation.

Your doctors may think there is a risk that cancer cells have been left behind after your operation. So they may recommend radiotherapy to kill off any remaining cancer cells. 

If Ewing's sarcoma spreads to the lungs

You might have radiotherapy to both of your lungs after chemotherapy if the cancer has spread to your lungs. This is sometimes called whole lung radiotherapy or a lung bath. You usually have a low dose of radiotherapy every day over a couple of weeks. 

Bone cancer that has spread or come back

You might have radiotherapy for all types of bone cancer that have spread or come back (advanced cancer). It might not be possible to get rid of advanced bone cancer. But radiotherapy and chemotherapy might control the growth of the cancer for a while.

This kind of radiotherapy is called palliative radiotherapy. Palliative radiotherapy can shrink advanced cancers and relieve symptoms. 

A growing cancer can cause symptoms by pressing on nerves and other body tissues. This can be painful. Radiotherapy can often shrink them which relieves the pressure.

Radiotherapy can also help to strengthen bones weakened by cancer. After the treatment has killed off the cancer cells, the holes in the bone caused by the cancer are repaired by the osteoblasts. These are the cells in bones that make the bone framework.

When and where you have radiotherapy

You have radiotherapy treatment in the hospital radiotherapy department at your cancer centre. You can't have all the radiation you need to kill the cancer in one go. That would cause too many side effects and too much damage to normal body tissue. 

External radiotherapy machine

You have the treatment broken up into a course of smaller dose treatments called fractions. You usually have a fraction every day, from Monday to Friday, with a rest at the weekend.

Most commonly, you have radiotherapy once daily, for a few weeks or days. For Ewing's sarcoma you might have radiotherapy and chemotherapy at the same time. This is called concurrent chemoradiotherapy.

Last reviewed: 
06 Dec 2017
  • UK guidelines for the management of bone sarcomas
    C Gerrand and others
    Clinical Sarcoma Research, 2016. Volume 6

  • Bone sarcomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up
    The ESMO/European Sarcoma Network Working Group
    Annals of Oncology, 2014. Volume 25, Supplement 3

  • Cancer and its Management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Radiotherapy in Practice: External Beam Therapy (2nd edition)
    Hoskin P
    Oxford University Press, 2012

  • Advances in radiotherapy
    S Ahmad
    British Medical Journal, 2012. Volume 345

  • Improving Outcomes for People with Sarcoma
    National Institute for Health and Care Excellence (NICE), 2006

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