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Neoadjuvant Chemotherapy Developed in Japan

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Osteosarcoma
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Abstract

Adjuvant chemotherapy is a standard treatment for osteosarcoma, which was verified by two randomized controlled trials (RCTs). Preoperative chemotherapy and limb-preserving procedure have been developed in the USA since around 1970 and in Japan since around 1980. In addition, histologic evaluation concerned with the rate of necrosis of excised tumors after preoperative chemotherapy has been tried, and it has been reported that patients with higher rate of necrosis result in better survival. Neoadjuvant chemotherapy for osteosarcoma (NECO) study tried to improve survival of the patients with lower rate of necrosis, called as “poor responders,” by the changes or addition of chemotherapeutic agents on the basis of the histologic evaluation in Japan, and the study found the possibility to rescue poor responders. Such strategies, however, have not been verified by RCT yet. Now additional effects of ifosfamide (IFO) to postoperative chemotherapy for poor responders after preoperative chemotherapy and surgery are just tested by two RCTs.

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Correspondence to Hiroaki Hiraga .

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Hiraga, H. (2016). Neoadjuvant Chemotherapy Developed in Japan. In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_7

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  • DOI: https://doi.org/10.1007/978-4-431-55696-1_7

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