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Abstract Regarding all the above mentioned studies [49,50,51,52,53], only 14 cases of malignant bone and soft tissue tumors of the upper extremity have been treated by en bloc resection, intraoperative extracorporeal irradiation, and reimplantation. Two of these cases were soft tissue tumors in the forearm and hand. Six cases were upper-extremity bone tumors. Six malignant bone tumors in the forearm and hand have been treated with this method, including 4 tumors in the radius, 1 tumor in the ulna, and 1 tumor in the metacarpal. There were two osteosarcomas, one malignant fibrous histiocytoma, and one intraosseous liposarcoma; two were unknown. One of 2 patients with tumor of the radius reported by Uyttendaele et al. [52] had normal mobility and elbow and wrist function at final follow-up examination, but the other patient developed osteomyelitis, followed by wrist arthrodesis. A patient with parosteal osteosarcoma in the ring finger metacarpal described by Revell et al. [53] had excellent finger movement 3 months after surgery: she was able to play the piano. A single dose between 50 and 200 Gy can completely sterilize tumor cells. Takahashi et al. [54] reported that animal studies of extracorporeal autograft irradiation at this low dose range showed excellent incorporation of bone grafts. Yamamoto et al. |