Adjuvant Therapy in the Management of Osteosarcoma: Need for Critical Reassessment
Until about 8 years ago, the prognosis for patients with osteosarcomas used to be extremely bad [3, 9, 14] in spite of the fact that the control of the primary tumor is usually achieved. As about 90% of these tumors arise in the long bones of the limbs, ablative surgery can usually be performed as a radical procedure and local recurrences are fairly rare. In some centers, mainly in France, radiotherapy is used as an alternative. As osteosarcomas are rather radioresistant tumors, very high radiation doses are necessary. Even though such treatment regimens sometimes lead to complications in the normal tissues, some local recurrences still do occur. However, both the sequelae and the tumor regrowth can usually be managed without great difficulty with ablative surgery. Although this policy is much more complicated and requires intensive follow-up of the patient, the possibility to preserve the limb in a fraction of the patients merits serious consideration.
KeywordsDepression Sarcoma Doxorubicin Methotrexate Cyclophosphamide
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- 3.Cohen, P.: Osteosarcoma of the long bones. Eur. J. Cancer, (in press) (1978).Google Scholar
- 6.Dahlin, D., Coventry, M.: Osteogenic sarcoma: A study of 600 cases. J. Bone Joint Surg. A 49, 101–110 (1967).Google Scholar
- 8.Fossati Bellani, F., Gasparini, M., Gennari, L., Fontanillas, L., Bonadonna, G.: Adjuvant treatment with adriamycin in primary operable osteosarcoma. Cancer Treat. Rep. 62, 279–281 (1978).Google Scholar
- 14.Marcove, R. C., Mike, V., Hajek, J. V., Levin, A. G., Butter, R. V. P.: Osteogenic sarcoma, under the age of twenty-one. J. Bone Joint Surg. A 52, 411–423 (1970).Google Scholar
- 20.Rosen, G., Marcove, R. C., Caparros, B., Cahill, L., Huvos, A. G.: Primary osteogenic sarcoma: the rationale for preoperative chemotherapy and delayed surgery. Cancer (in press) (1978).Google Scholar
- 22.Sutow, W. W.: Perspectives in the management of osteosarcoma and rhabdomyosarcoma in children. Management of primary bone and soft tissue tumors, pp. 25–34, Year book medical publishers, Chicago, 1977.Google Scholar
- 24.Sutow, W. W., Gehan, E. A., Vietti, T. J., Frias, A. E., Dyment, P. G.: Multidrug chemotherapy in primary treatment of osteosarcoma. J. Bone Joint Surg. A 58, 629–633 (1976).Google Scholar
- 25.Sutow, W. W., Sullivan, M. P., Fernbach, D. J.: Adjuvant chemotherapy in primary treatment of osteogenic sarcoma. Proc. Am. Assoc. Cancer Res. 15, 20 (Abs.) (1974).Google Scholar
- 27.Taylor, W. F., Ivins, J. C., Dahlin, J. V., Pritchard, D. J.: Osteogenic sarcoma experience at Mayo Clinic, 1963–1974. Immunotherapy of cancer: present status of trials in man. Terry, W. D., Windhorst, D. (eds.), pp. 257–269. New York: Raven Press 1978.Google Scholar
- 28.Wilbur, J. R., Etcubanas, E., Long, T., Glatstein, E., Leavitt, T.: Drug therapy and irradiation in primary and metastatic osteogenic sarcoma. Proc. Am. Assoc. Cancer Res. 15, 188 (Abs.) (1974).Google Scholar