Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with osseous malignant lesions were treated with the tourniquet infusion method. The first patient, with two metastatic lesions in the left femur resulting from a renal adenocarcinoma, had three courses of intra-arterial Adriamycin. Biopsies of these lesions showed that the distal lesion, which was perfused during each treatment, was histologically negative, whereas the proximal lesion, which was not perfused because of the position of the catheter, contained the viable tumor. The second patient, a 12-year-old girl with osteogenic sarcoma of the proximal portion of the right tibia, had three courses of intra-arterial chemotherapy with Adriamycin and cisplatinum, and then underwent open biopsy, which was histologically negative. Another open biopsy six months later was also histologically negative. She has normal use of her extremity and, at eleven months since the initiation of treatment, she remains disease free. The evaluation of the tourniquet infusion technique in greater numbers of patients with bone tumors under carefully controlled conditions, appears warranted.
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PMID:Tourniquet infusion chemotherapy for osseous malignant lesions. 386 90

During the past 10 years, (November, 1973 through November, 1983) 208 patients with fully malignant primary osteogenic sarcoma of an extremity were treated with preoperative chemotherapy on 4 successive treatment protocols. Continuous improvements in the disease-free survival of patients were attributed to refinements in the chemotherapy regimens. These refinements were made after direct observation of the response of the primary tumor to chemotherapy. At a minimum follow-up time of over 38 months for 87 patients treated on the T-10 chemotherapy protocol, 67 (77%) have remained alive and continuously free of disease, and 71/87 (81.6%) are currently free of disease at a median follow-up time of 5 years. Overall complete response rate of the primary tumor to preoperative chemotherapy was 48%. Fifty-one patients were treated on a pilot protocol (T-12) from November, 1981, to November, 1983. The main difference was that after preoperative high dose methotrexate and combination bleomycin, cytoxan and dactinomycin therapy, patients having a good histologic response of the primary tumor (21/51 or 41%) had their chemotherapy stopped at 15 weeks and did not receive platinum or Adriamycin chemotherapy. 38/51 (75%) on T-12 remained continuously free of disease and 39/51 (76%) are currently alive and free of disease. There were 2 local recurrences on the T-10 protocol and 6 on the T-12 protocol. Excluding local recurrences 71/85 (84%), patients treated on T-10 are currently alive and free of disease and 38/45 (84%) patients treated on T-12 are alive and free of disease (at a median follow-up of 24 months for T-12). This preliminary study indicates that preoperative chemotherapy may be used to select a subset of patients (who respond well to preoperative high dose methotrexate) who can have therapy terminated early, sparing those patients the undesirable side effects and cost of additional therapy with platinum and Adriamycin.
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PMID:Neoadjuvant chemotherapy for osteogenic sarcoma: a five year follow-up (T-10) and preliminary report of new studies (T-12). 386 2

High-dose methotrexate with citrovorum factor "rescue" (MTX-CF) produced an apparent complete response of the primary tumor in three patients with osteosarcoma. The response was sustained with MTX-CF, intra-arterial cis-diamminedichloroplatinum II (CDP) and Adriamycin (doxorubicin) for 18 months. Treatment was then electively discontinued. Local recurrence occurred in two patients, 6 and 4 months later, respectively. MTX-CF was reinstated and a complete response was again achieved in one patient. This has been maintained for 15+ months with MTX-CF and intra-arterial CDP administered for 13 of the 15+ months. Reinduction with MTX-CF failed in the second relapsed patient but an apparent remission was again achieved with radiation and intra-arterial CDP. This has been maintained with intravenous CDP, cyclophosphamide and phenylalanine mustard for 14+ months. A complete response in the primary tumor was still present in the nonrelapsed patient, 42 months from diagnosis. All patients have remained free of pulmonary metastases, 40+ to 42+ months from diagnosis.
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PMID:Control of primary osteosarcoma with chemotherapy. 387 85

Sarcomas of childhood rank fifth in incidence of malignant tumors in children younger than 15 years. Among the soft tissue sarcomas, approximately 50% are rhabdomyosarcomas. The remainder represent a heterogeneous group of diverse sarcomas which are not unique to children and include fibrosarcoma, synoviosarcoma, malignant fibrous histiocytoma, malignant schwannoma, angiosarcoma, leiomyosarcoma, and others. The most common bone cancers in childhood are osteosarcoma and Ewing's sarcoma. Although a multidisciplinary approach utilizing surgery, irradiation, and combination chemotherapy is routinely used in management of virtually all children with solid tumors, the value of adjuvant chemotherapy in select bone and rare soft tissue sarcomas is currently being tested. Multiagent chemotherapy including vincristine, dactinomycin, cyclophosphamide, and Adriamycin (doxorubicin) contribute to cure rates in 65% to 75% of children with localized rhabdomyosarcoma, Stages I to III, when combined with surgery and/or irradiation. Other drugs which hold promise include platinum, DTIC, methotrexate, and VP-16. The efficacy of similar drugs in the rarer pediatric soft tissue sarcomas other than rhabdomyosarcoma and its variants requires prospective randomized trials evaluating histologic grade, tumor size, and nodal status. It has been suggested that the high-grade sarcomas presenting with minimal tumor bulk are most sensitive to combined radiotherapy-chemotherapy, whereas the low-grade sarcomas are more resistant to such therapy. Tumor cell heterogeneity contributes to biologic diversity and response to treatment. Chemotherapy as adjuvant therapy to irradiation is currently recommended and utilized for Ewing's sarcoma with survival rates approaching 80%, and disease-free survival of approximately 75% for those with localized disease. Children with widespread and metastatic disease at presentation fare less well. Although multiple single agents exhibit response rates ranging from 40% to 60%, including cyclophosphamide, Adriamycin, dactinomycin, BCNU, mithramycin, and 5-fluorouracil, new and more effective agents are needed. Controversy regarding the value of multiagent chemotherapy in osteosarcoma has stimulated prospective randomized trials. Evaluation of local control rates as well as sites and occurrence of metastases are essential in assessing the contribution of aggressive combined modality therapy in the pediatric sarcomas. Emphasis on refinement of therapy in determining the risk/benefit ratio from adjuvant chemotherapy in pediatric sarcomas is mandatory. Enhancement of early local reactions is apparent when adjuvant chemotherapy is used with local radiotherapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The value of adjuvant chemotherapy in the management of sarcomas in children. 388 37

Since June 1978, 57 patients with primary osteogenic sarcoma of an extremity were treated with high-dose methotrexate (HDMTX) and citrovorum factor rescue (CFR), Adriamycin, and the combination of bleomycin, cyclophosphamide and dactinomycin (BCD) given for 4-16 weeks prior to definitive surgery. Histologic examination of the resected primary tumor determined the effect of preoperative chemotherapy with many primary tumors showing greater than 90% tumor necrosis attributable to preoperative chemotherapy. All patients having this favorable effect of chemotherapy on the primary tumor were continued on the same chemotherapy regimen postoperatively (regimen B). However, in those patients not having a good effect of preoperative chemotherapy on the primary tumor, HDMTX with CFR was subsequently deleted from their postoperative chemotherapy and they were placed on a regimen containing cisplatinum at the dose of 120mg/M2 with mannitol diuresis combined with Adriamycin in addition to BCD (regimen A). In the current study, 35 of the 57 patients did not demonstrate a good effect of chemotherapy on the primary tumor and were assigned to regimen A postoperatively. Of these 35 patients, 32 (91%) have remained continuously free of recurrent or metastatic disease from 6-34 months following the start of therapy. Among the 22 remaining patients having a good histologic response and treated with regimen B postoperatively, there has been only one relapse in a patient who had a local recurrence in the area of an inadequately resected primary tumor three months after the cessation of chemotherapy. Thus, 53 of 57 patients (93%) are continuously with no evidence of recurrent or metastatic disease from 6-35 months (median, 20 months) from the start of treatment. This study demonstrates the value of thorough histologic examination in predicting survival in responding patients and in helping identify patients whose disease-free survival rate can be substantially increased if they are given alternative postoperative adjuvant chemotherapy after failing to have a good response to preoperative chemotherapy. This individualized chemotherapeutic strategy has yielded the highest disease-free survival rate reported to date for osteogenic sarcoma.
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PMID:Preoperative chemotherapy for osteogenic sarcoma: selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy. 617

Three cases of heterologous sarcomas of the uterus are presented. Two were mixed tumors; one was a lipoleiomyosarcoma; and one was an osteogenic sarcoma with leiomyosarcoma. The third was a rhabdomyosarcoma. These tumors are believed to behave more aggressively than mixed mesodermal tumors. Six months after initial diagnosis, the lipolieomyosarcoma had metastasized to a vertebra. Following radiation therapy, the metastases recurred at the same site. The rhabdomyosarcoma of the uterus produced lung metastases 4 months following surgery, and the patient died 14 months after initial diagnosis despite extensive chemotherapy. The patient with osteogenic sarcoma of the uterus with leiomyosarcoma had been treated with Adriamycin and is alive and well 1 year following initial diagnosis. The histogenesis of these tumors is reviewed.
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PMID:Heterologous sarcomas of the uterus. 630 4

The primary site of metastasis of bone and soft tissue sarcoma is the lung. Control of these sarcomas depends upon the prevention and treatment of their pulmonary metastasis. The introduction of a chemotherapy consisting mainly of Adriamycin and high-dose methotrexate dramatically improved the prognosis of osteosarcoma. However the effectiveness of chemotherapy has not yet been duplicated in soft tissue sarcomas except some childhood sarcomas. We analyzed the clinical data for pulmonary metastasis of osteosarcomas and soft tissue sarcomas. Based on these analyses, we tried to clarify the nature of pulmonary metastasis of these sarcomas and to evaluate its response to treatment, that this would yield clues to future treatment of these sarcomas.
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PMID:[Chemotherapy of advanced bone and soft tissue sarcoma]. 654 Oct 20

A unique case of a 15-year-old boy with complete paraplegia due to the compression of osteogenic sarcoma at the fourth thoracic vertebra is presented. Because of the difficulty of surgical treatment, he was treated merely by the arterial infusion of Adriamycin (doxorubicin) and systemic chemotherapy in conformity with the cyclophosphamide, Oncovin (vincristine), methotrexate, phenylalanine mustard, Adriamycin (doxorubicin) ( COMPADRI )-III regimen. The patient regained normal function, and has been disease-free without any neurologic deficit for 6 years. There appears to be some hope for cure using chemotherapy only in otherwise unpromising patients.
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PMID:Osteogenic sarcoma of the fourth thoracic vertebra. Long-term survival by chemotherapy only. 658 74

Conventional treatment for high grade and large sarcomas uses a radical surgical approach, including amputation, in many patients. We evaluated a limb-sparing treatment approach using preoperative regional Adriamycin chemotherapy and rapid-fraction radiation therapy. Thirty patients with soft tissue or skeletal sarcoma were treated in a prospective, nonrandomized clinical trial to evaluate local disease control and limb salvage in these patients who would otherwise require amputation or face a high risk of local recurrence with surgical excision. Almost all patients had large tumors with grade III histologic findings. All patients had a three day intra-arterial regional chemotherapy infusion with Adriamycin (100 milligrams total dose), followed within ten days by rapid-fraction irradiation (3,000 rads over a two week period) prior to surgical excision of the tumor. The size and location of the sarcoma permitted only a marginal resection in one-half of the patients, while the remainder could be excised in a three dimensional en bloc manner. Almost all patients received post-operative systemic Adriamycin chemotherapy (450 milligrams per square meter given intravenously over a six month period). Two of six patients with significant wound complications later required amputation. Only one patient (3 per cent) has had a local recurrence of sarcoma develop after a mean follow-up of 22 months (range nine to 42 months), and 90 per cent of the patients have a useful extremity. The three year survival rate was 68 per cent for soft tissue sarcomas, compared with an expected survival rate of 38 per cent for published historical control studies. The patient with osteogenic sarcoma has a projected 83 per cent survival rate at 18 months after treatment. This multimodality approach is an effective treatment for local disease control in patients with high risk sarcoma. It permits limb salvage in most patients without compromising the survival rates.
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PMID:Preoperative regional chemotherapy and rapid-fraction irradiation for sarcomas of the soft tissue and bone. 658 4

The relationship between total surface antigen expression per cell (means) - measured by fluorescence-labelled monoclonal antibodies (fluorescence-histograms) and the distribution of cells in the cell cycle (DNA-histograms) and size-scattergrams (cell sorter FACS-IV) were analysed in drug treated unsynchronized and synchronized osteogenic sarcoma cells (2OS) in vitro. Drugs with various sites of action in the cell cycle were used. Adriamycin, Vindesine, in concentrations applied accumulate cells in G2 + M phase. Methotrexate arrests cells in the boundary of G1/S phase. Size-scattergram and DNA-histogram analysis have shown that the entrance of cells to the cell cycle is usually accompanied by an increase in the cells size and amount of their DNA. The size of the cells influenced antigenic expression much more than the distribution of the cells in the various cell cycle phases: in the bigger cells the expression per cell was more pronounced. The increase of antigen expression was the highest for Adriamycin and for Methotrexate treated cells. However, this increase was limited and never exceeded plus 50% in relation to the control. This relatively low difference resulted from the fact, that a given phase of the cell cycle included cells markedly heterogenic in respect of size and antigenic content. It was also shown that lower concentration of serum in culture medium and confluent growth of older cultures decrease surface antigen expression per cell.
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PMID:Analysis of surface antigen expression per cell of human osteogenic sarcoma cells by fluorescence-labelled monoclonal antibodies. 659 41


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