The question in this case centers on what can possibly be done to help relieve the patient's pain. Resection of the bone invloved with tumor followed by reconstruction and stabilization of the spine to the pelvis are the possible options. Resection of the involved areas of bone would be a heroic and risky undertaking, which would not likely result in significant relief of pain. The extensive radiation that has been given virtually guarantees severe wound complications, poor healing, infection, and resulting excess morbidity. Stabilization of the spine to the pelvis appears to be limited by the extensive damage to the ilia on both sides, thereby severely limiting the bone available for fixation. In addition, the extensive dissection required for implantation of stabilization devices would result in the same risk of severe wound complications due to the high doses of radiation that have been given. It appears that surgical intervention is not appropriate in this case.