Bone tumours: radiotherapy in Ewing sarcoma: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone tumours: radiotherapy in Ewing sarcoma

Sample item

A 14-year-old with Ewing sarcoma of the iliac bone has completed neoadjuvant chemotherapy, and wide resection would leave a major deficit. Which local treatment is an accepted alternative because this tumour is sensitive to it?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Definitive radiotherapy

Ewing sarcoma is highly radiosensitive, so radiotherapy is used for local control when the primary site, such as the pelvis or spine, makes complete resection impractical. This differs from osteosarcoma, which is radioresistant and relies on surgery.

Option by option

  • A. Intralesional curettage with cement

    Curettage with cement is an intralesional procedure used for benign aggressive tumours.

  • B. Bisphosphonate infusion

    Bisphosphonates do not control a primary small round cell sarcoma.

  • C. Cryosurgery alone

    Cryosurgery alone is not an established local treatment for Ewing sarcoma.

  • D. Definitive radiotherapy (correct)

    Correct. Radiosensitivity makes definitive radiotherapy a recognised option for unresectable sites.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Definitive radiotherapy. Ewing sarcoma is highly radiosensitive, so radiotherapy is used for local control when the primary site, such as the pelvis or spine, makes complete resection impractical.

Why is "Intralesional curettage with cement" not the answer?

Curettage with cement is an intralesional procedure used for benign aggressive tumours.

Why is "Bisphosphonate infusion" not the answer?

Bisphosphonates do not control a primary small round cell sarcoma.

Why is "Cryosurgery alone" not the answer?

Cryosurgery alone is not an established local treatment for Ewing sarcoma.

What concept does this question test?

It tests Bone tumours: radiotherapy in Ewing sarcoma in Orthopaedics. This differs from osteosarcoma, which is radioresistant and relies on surgery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone tumours: radiotherapy in Ewing sarcoma?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.