Local recurrence of tumor cells are a risk associated with marginal or intralesional tumor resection. To prevent additional local growth, a bone cement containing an anticancer drug was developed. Two cases of pathological fractures associated with metastatic bone tumors of lower extremities were treated by local resection, using bone cement with pirarubicin (THP) to reinforce internal stabilization and to fill defects. THP 30mg to 40mg, was sealed into the bone cement (40mg). Case 1, was a 69-year-old man who had femoral and tibial metastases from a renal cell carcinoma. Case 2, was a 77-year-old man who had tibial metastases from lung cancer, which was unknown before operation. Postoperatively, THP concentration in suction drainage and plasma were measured in series. The local concentration was much higher than that in the plasma, whereas the systemic concentration remained at a minimum level. In both cases, the patients could walk with or without a cane even temporarily. These results indicate that THP loaded bone cement can be used in the treatment of skeletal metastases.
