Abstract
Due to population ageing, the number of elderly patients with malignant bone and soft tissue tumours including metastatic bone tumours has been increasing. We herein describe the means and ideas to improve therapeutic outcome of the elderly patients with such tumours. When the tumour is curable, wide excision of the lesion should be performed as a general rule. However, when wide excision is too invasive for the elderly, less invasive surgery may be performed with adjuvant intra- or post-operative radiotherapy, or with photodynamic therapy. Heavy particle beam therapy may be performed instead of surgery. Adjuvant chemotherapy may be performed for primary malignant tumours after due consideration of the patients’ general conditions. When the tumour is incurable, the final goal is to improve the patients’ ADL and QOL. Metastatic bone tumour is the typical case, most of which is accompanied by pathological fracture. Internal fixation, usually followed by radiotherapy, is performed for pathological fracture of long bones to improve ADL. Since postoperative deterioration of ADL is the most serious matter in elderly patients, commencing rehabilitation exercise in early stage after surgery is mandatory.
