A new limb salvage surgery in cases of high-grade soft tissue sarcoma using photodynamic surgery, followed by photo- and radiodynamic therapy with acridine orange

J Surg Oncol. 2008 May 1;97(6):523-8. doi: 10.1002/jso.21025.


Background: To maintain excellent limb function after tumor resection in patients with high-grade malignant sarcomas, we developed and established a new surgical adjuvant therapy using acridine orange (AO) after intra-lesional or marginal resection while sparing normal tissues of major nerves, vessels or bones adjacent to the tumor.

Method: Our AO therapy procedure was combined with photodynamic surgery (PDS), photodynamic therapy (PDT) and radiodynamic therapy (RDT). In this study, 26 patients with primary high-grade soft tissue sarcomas were treated with AO therapy.

Result: Results showed a low local recurrence rate (7.7%) and good local recurrence-free rate (88%) after AO therapy. Limb function of all patients was maintained at 100% of ISOLS criteria.

Conclusion: Based on these results, we concluded that AO therapy is useful for local control after margin-positive tumor resection and for preserving excellent limb function in patients with high-grade soft tissue sarcomas.

Publication types

  • Case Reports

MeSH terms

  • Acridine Orange / therapeutic use*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / therapy*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Fluorescent Dyes / therapeutic use*
  • Humans
  • Infant
  • Limb Salvage*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Photochemotherapy*
  • Radiotherapy, Adjuvant
  • Sarcoma / drug therapy
  • Sarcoma / radiotherapy
  • Sarcoma / therapy*
  • Soft Tissue Neoplasms / drug therapy
  • Soft Tissue Neoplasms / radiotherapy
  • Soft Tissue Neoplasms / therapy*
  • Treatment Outcome
  • X-Ray Therapy


  • Fluorescent Dyes
  • Acridine Orange