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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From January 1978 to May 1983, 41 patients with primary high-grade osteogenic osteosarcoma of a limb were treated with a combination of intensive chemotherapy and prophylactic lung irradiation (PLI) intercalated between the first two cycles of chemotherapy. The primary tumor was treated according to its size and location by amputation, resection, high-dose radiotherapy, and salvage amputation for a tumor progressing under radiotherapy. Two weeks after surgery or simultaneously with radiotherapy, a three-drug regimen (cycle A) consisting of mitomycin C on day 1, vincristine followed by a 6-hour infusion of methotrexate on day 2 was given. Folinic acid rescue was started 6 hours after the end of the methotrexate infusion. A PLI of 20 G was given from day 10 to 22. On day 28, a four-drug regimen (cycle B) combining doxorubicin on day 1, vincristine on day 2 and dacarbazine with cyclophosphamide on days 3 to 6 was administered. Thereafter, five additional cycles of A and B were administered provided that the absolute number of polymorphonuclear cells and platelets had recovered. When these values were not attained, treatment was delayed until recovery. After a mean follow-up of 60.6 months, 16 patients have developed distant metastases, associated in four cases with local recurrence. Sixteen patients have died: 15 with metastases, one with no evidence of disease (toxic death). The overall survival of the entire group is 66% and the continuously disease-free survival 58% at 5 years. Alopecia, nausea, vomiting, asthenia, anorexia, and infraclinical and reversible impairment of lung ventilatory function were universal. A noticeable hematologic toxicity also was seen. One toxic death occurred after a pulmonary infection. Two patients developed cardiomyopathy. A multiparametic analysis of prognostic factors shows the very significant influence of age on treatment outcome. The continuous disease-free survival among the 17 patients younger than 15 years is 41% compared to 79% in older patients. The prognostic influence of age was independent of other factors. The delay (for more than two cycles) of methotrexate administration was the second independent prognostic factor. These results raise the question of using different protocols of adjuvant chemotherapy for patients younger or older than 15 years in order to optimize the curability/toxicity ratio.
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PMID:Age and dose of chemotherapy as major prognostic factors in a trial of adjuvant therapy of osteosarcoma combining two alternating drug combinations and early prophylactic lung irradiation. French Bone Tumor Study Group. 312 57

The data on 26 patients with solitary metastatic lesions arising in cortical bone were studied. Nineteen patients were over 50 years of age. In 19 patients, the cortical metastasis was the first indication of the presence of a primary malignant condition. In seven cases, cortical metastases developed in patients with a known primary tumor. The primary tumors involved were eight renal cell carcinomas, six bronchogenic carcinomas, two carcinomas of the gastrointestinal tract, one osteosarcoma, one neuroblastoma, one melanoma, one hepatoma, one carcinoma of the breast, and one thyroid carcinoma. In four cases, the primary tumor remained unknown. A metastatic origin should be considered in the differential diagnosis of an osteolytic lesion arising in the cortex of a long bone, especially in older patients and in patients with a known primary malignant condition. The cortical bone metastases encountered in this study did not originate solely from bronchogenic carcinoma, as has been reported by other authors. Cortical metastases are probably less rare than has been hitherto assumed.
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PMID:Cortical bone metastases. 317 2

The European Organization for Research on Treatment of Cancer (EORTC) trial 20781, concerning osteosarcoma of the limbs is reported. After definitive treatment of the primary tumor with amputation or irradiation, adjuvant treatment was given, randomized into either 9 months of chemotherapy according to a modified Rosen schedule, or elective bilateral lung irradiation of 20 Gy, or 3 months of chemotherapy followed by lung irradiation. The 4-year disease-free survival and total survival were 24% and 43%, respectively, with no difference between the treatment arms. In the radiotherapy arms the lung metastases were more frequently suitable for surgical treatment. The survival of patients with either tibia localizations or higher age was somewhat better. Local recurrences occurred in 16% of patients, 50% of them with distant metastases. The trial was executed from 1978 to 1983; 205 patients were evaluable and eligible, and three toxic deaths occurred in the chemotherapy arms. Elective lung irradiation provided the same survival as the adjuvant chemotherapy given in that time.
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PMID: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. 327 90

A case of a sclerosing variant of osteosarcoma of a toe phalanx is reported in a 28-year-old man. This represents the first reported case of osteosarcoma of any kind at this site. This is based on a review of 4,214 cases of conventional osteosarcoma. The reason for the extraordinary rarity in toe or hand phalanges is unknown although osteosarcoma is the second most common primary tumor of bone. Since the neoplasm had minimal signs of cytologic anaplasia, it was originally mistaken for and treated as an osteoid osteoma. The lesion recurred and extended into soft tissues. Reevaluation revealed the tumor to be an osteosarcoma, sclerosing variant with "normalization" of nuclei. The lesions that this tumor should be distinguished from are osteoid osteoma and osteoblastoma.
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PMID:Primary osteosarcoma of toe phalanx: first documented case. Review of osteosarcoma of short tubular bones. 328 81

Methotrexate (MTX) has demonstrated significant activity against relapsed and metastatic osteosarcoma. However, there is little published data to indicate the appropriate dose for MTX when given as a component of a multidrug regimen for the treatment of osteosarcoma. Therefore, the investigators at the Childrens Cancer Study Group undertook a randomized clinical trial that compared Adriamycin and vincristine given with either high-dose methotrexate or moderate-dose methotrexate as postoperation chemotherapy in the treatment of childhood osteosarcoma. We report here the results for 166 patients with completely resected nonmetastatic disease of an extremity. The two therapies demonstrated equivalent disease-free survival (DFS). Further, no therapy prejudices survival after relapse. Approximately 38% of patients remain disease free 4 years after diagnosis. Two relapses occurred in patients free of disease at least 36 months after initiation of treatment. Some factors found by other investigators to be prognostic of poorer DFS, namely, male sex, primary tumor in the humerus or femur, and larger primary tumors, demonstrated similar though not statistically significant trends. The presence of spontaneous necrosis in the tumor sample from the definitive surgery was associated with poor prognosis for DFS. We postulate that this feature represents rapidly growing tumors with increased potential for metastases.
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PMID:A randomized study comparing high-dose methotrexate with moderate-dose methotrexate as components of adjuvant chemotherapy in childhood nonmetastatic osteosarcoma: a report from the Childrens Cancer Study Group. 329 1

Osteosarcoma is a rare malignant tumor of bone that produces osteoid. Most tumors arise in the metaphyses of long bones. At least 80 per cent of patients have subclinical metastases at diagnosis. Successful management of osteosarcoma requires surgical control of the primary tumor and chemotherapeutic control of systemic metastases. Wide resection of primary tumor is often compatible with limb-sparing surgery. Multiagent chemotherapy has significantly enhanced disease-free survival. Osteosarcoma metastasizes to lung and other bones. Aggressive surgical resection can sometimes control pulmonary metastases; bony metastases are almost always followed by death.
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PMID:Malignant bone tumors in children: osteosarcoma. 332 77

The introduction of chemotherapy has greatly changed the treatment of osteosarcoma. During the preoperative phase the tumor response to chemotherapy can be assessed in various ways. This paper discusses the clinical, histological and radiological response to preoperative chemotherapy in three patients. Changes in conventional roentgenograms following chemotherapy can reflect the effect of chemotherapy on the primary tumor. This can be important in planning further chemotherapy or surgery.
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PMID:The effect of chemotherapy on osteosarcoma of the extremities as apparent from conventional roentgenograms. 346 51

The experience in the management of 246 patients with local osteogenic sarcoma and 67 patients with pulmonary metastases in the All-Union Oncologic Research Center, AMS USSR, is presented here. All the patients underwent surgery, but starting in 1974, various modalities of adjuvant chemotherapy (not randomized) were applied in addition. In the surgery alone group, prognosis was very poor: only 7.0% of patients survived free of disease 5 years from the primary tumor treatment. Adjuvant chemotherapy (adriamycin + vincristine + melphalan + cyclophosphamide) following amputations increased this rate to 34.0%; combining segmental resections of an affected bone with preoperative intraarterial adriamycin infusion and radiation (36 Gy) increased the rate to 35.5%. In patients with grade 4 tumor damage (tumor cells are not found upon examination of a large number of sections), the rate increased to 57.9% (P less than .05). Another regimen of adjuvant chemotherapy (platidiam or cisplatin + adriamycin + cyclophosphamide) gives a chance to 78.8% of patients to survive 1 year free of metastases. The same chemotherapy regimen enables us to achieve an objective effect in 30.8% of patients with pulmonary metastases, and its combination with surgical metastasis ablation makes it possible to obtain a complete remission, lasting from 2 to 46 months (average 13.9 months). Toxic manifestations of the chemotherapy regimens considered are moderate. Prognosis in adjuvant chemotherapy is related to age, tumor site, its local dissemination, and morphologic type of osteogenic sarcoma.
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PMID:Management of osteogenic sarcoma patients. 346

Cisplatin was used in 14 bone and soft tissue sarcomas. Severe vomiting developed in all cases, but the duration was relatively short. Renal function was disturbed in cases with a higher total dose. This side effect was considered to be the dose-limiting factor of cisplatin. Seven cases showed high-frequency deafness but they did not complain of disturbance during conversation. In seven metastatic osteosarcomas, one was evaluated as a partial response and one as a minor response. No response was observed among three soft tissue sarcomas. Three cases of osteosarcoma receiving cisplatin in adjuvant chemotherapy have been disease-free for 4 and 46 months after resection of pulmonary metastases and for 50 months after resection of the primary tumor. We consider cisplatin to be the first-choice drug in cases resistant to adriamycin or methotrexate, but there are some problems when cisplatin is used in adjuvant chemotherapy, because of its side effects.
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PMID:[Chemotherapy using cisplatin in bone and soft tissue sarcoma]. 346 52

The cytostatic and antimetastatic activities of 1,2-di(3,5-dioxopiperazin-1-yl) propane (ICRF-159, razoxane) were studied in a transplantable, slowly growing osteosarcoma in Sprague-Dawley rats. This tumor model is characterized by osteoid formation and spontaneous metastasization to lungs, kidneys and lymph nodes. Razoxane given intraperitoneally (i.p.) from 2 days before to 14 days after tumor transplantation (30 mg/kg or 10 mg/kg per day) resulted in a dose-dependent prolongation of median survival time (83 or 48 days respectively, versus 38 days for the control group), but showed no influence on the growth of the primary tumor. Early treatment with razoxane (30 mg/kg i.p. from day -2 to +14) showed a greater inhibition of pulmonary metastases than later treatment (30 mg/kg i.p. from day +14 to +28 after transplantation). Whereas 59.9 per cent of the total sectional area of the lungs in the control animals was covered by osteosarcoma metastases, only 3.4 per cent and 26.1 per cent respectively was affected in the early and late razoxane treatment groups. Toxic side-effects of these treatment schedules were reversible diffuse alopecia, but no retardation of body weight gain.
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PMID:Antimetastatic effects of razoxane in a rat osteosarcoma model. 347 Jan 64


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