Is there a rational role for radiotherapy in the treatment of osteosarcoma?

  • E. A. Bleher
Part of the Cancer Treatment and Research book series (CTAR, volume 62)


Up to 1974, The therapy of osteosarcoma consisted of surgery and radiotherapy. With amputation alone, 25–30% of patients could survive for 2 years and 80% of all patients died of distant metastases up to 15 years after the diagnosis [1]. According to Cade [2], local radiotherapy with 7000–8000 cGy was given and the operation was deferred by 6 months in order to obviate unnecessary amputations in patients with distant metastases occurring in these 6 months. A 5-year actuarial survival of 21.8% can be achieved with radiotherapy and delayed surgery. Because of effective prophylaxis or treatment of metastases with methotrexate [3], radiotherapy has since been replaced by even more effective chemotherapy schedules, and therefore in subsequent years radiation therapy was omitted and was only used palliatively or in the rarer locations in the pelvis and the visceral cranium, as well as in elderly patients.


Limb Salvage Rational Role Pubertal Growth Spurt Endoprosthetic Replacement Fast Neutron Radiotherapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Morton DL, Storm FK, Eilber FR. Surgical management and limb salvage in osteogenic sarcoma. In: Bone Tumours and Soft-Tissue Sarcomas. D’Angio GJ, Evans AE, Eds. E. Arnold, London, 1985, pp 134–139.Google Scholar
  2. 2.
    Cade, S. Osteogenic sarcoma—a study based on 133 patients. JR Coll Surg Edinb 1:79–111, 1955.Google Scholar
  3. 3.
    Jaffe N, Farber S, Traggis D, et al. Favorable response of osteogenic sarcoma to high dose methotrexate with citrovorum rescue and radiation therapy. Cancer 31:1367–, 1973.Google Scholar
  4. 4.
    D’Angio GJ, Evans AE. Bone tumours—a commentary. In: Bone Tumours and Soft-Tissue Sarcomas. D’Angio GJ, Evans AE, Eds. E. Arnold, London, 1985, pp 121–133.Google Scholar
  5. 5.
    Carter SR, Sneath RS, Grimer RJ. Growing endoprosthetic replacements for malignant tumours of bone. Int Sympos Limb Salvage. 6–9 Sept 1989, St. Malo, abstract 58.Google Scholar
  6. 6.
    Purgers JMV, van Glabbeke M, Busson A, et al. Osteosarcoma of the limbs: report of the EORTC-SIOP 03 trial 20781 investigating the value of adjuvant treatment with chemotherapy and/or prophylactic lung irradiation. Cancer 61:1024–1031, 1988.CrossRefGoogle Scholar
  7. 7.
    Yamamuro T, Kotoura Y. Intraoperative radiation therapy for osteosarcoma. In: Osteosarcoma, New Developments, Controversies and Current Practice. Kluwer, Ed. Academic, Boston, pp 00-00, 1992.Google Scholar
  8. 8.
    Takada N, Hodaka E, Umeda T, Hayashi H. Fast neutron radiotherapy in the treatment of limb-salvage surgery in patients with osteosarcoma. Gan To Kagaku Ryoho 14:1405–1411, 1987.PubMedGoogle Scholar
  9. 9.
    Overgaard J, Larson L-G, Eds. Fractionation in radiotherapy. Acta Oncologia 27:83–194, 1988.Google Scholar
  10. 10.
    Lartigau E, Saunders MI, Dische S, et al. A comparison of the late radiation changes after three schedules of radiotherapy. Radiother Oncol 20:139–148, 1991.PubMedCrossRefGoogle Scholar
  11. 11.
    Burgers JMV. Experience of the EROTC Radiotherapy/Chemotherapy trials. In: Osteosarcoma, New Developments, Controversies and Current Practice. Kluwer Academic, Boston, pp 00-00.Google Scholar
  12. 12.
    Bertoli RJ, Brady LW, Thomas PRM. Tumors of the bone. In: Principles and Practice of Radiation Oncology. Perez CA, Brady LW, Eds. J.B. Lippincott, Philadelphia, 1987, pp 1162–1181.Google Scholar

Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • E. A. Bleher
    • 1
  1. 1.Department of RadiooncologyThe University of Bern, InselspitalFrieburgstrasseBern

Personalised recommendations