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

Recent advances in the use of chemotherapy for treatment of osteosarcoma have altered out pessimism in this disease. Results are presented from 3 groups of investigators using different agents as adjuvant chemotherapy following immediately upon amputation of the primary. The Roswell Park Memorial Institute began a regime, immediately after amputation, of adriamycin 30 mg/M2 for 3 doses and given every 4-6 weeks. This study was subsequently expanded in a cooperative group (ALGB) and the results on 20 patients analyzed. At 19 months approximately 75 per cent are free of any pulmonary metastases compared with 10-25 per cent expected from amputation alone. Similar results have been obtained by other Centers using different chemotherapeutic agents. In Boston Children's Hospital high dose Methotrexate with citrovorum factor is used. In 12 of these patients local control of the primary by surgery was obtained and of these only 1 developed pulmonary metastases during an observation time of 23 months. At the M. D. Anderson Hospital multi-drug combinations were used including Cyclophosphamide, Vincristine, L-Phenylalamine Mustard and Adriamycin. They reported a survival rate of 55 per cent (10 out of 18). All of these neoplastic agents have toxic side effects but when carefully used these effects are minimized and the quality of life is quite good. Many questions must be answered by future controlled long term follow-up studies.
Clin Orthop Relat Res 1975 Sep
PMID:Chemotherapy of osteosarcoma. 105 62

Regrettably amputation remains to the present day an essential part of treatment in osteosarcoma of the limb bones. Only by its inclusion in the therapeutic regime can the present best level of about 20 per cent survival be achieved in any large group of patients. Preliminary biopsy is essential and there is no evidence that it is harmful even if followed by a delay of many days before definitive treatment. In patients treated initially by radiotherapy, selective amputation some 6 months later only in patients free of metastases, carries just as good a prognosis for the group as a whole as initial primary amputation in all patients. This method, first described by Cade, is widely practiced in the United Kingdom and spares many patients who develop early metastases following initial radiotherapy from unnecessary mutilating surgery shortly before inevitable death. Local recurrence may follow retention of a femoral stump following amputation for osteosarcoma at the most common site in the lower femoral metaphysis. There are cogent arguments in favor of hip disarticulation in such patients although they do not include evidence of greater survival. The balance between the two procedures is finely drawn but is weighted in favor of disarticulation.
Clin Orthop Relat Res 1975 Sep
PMID:The surgical management of primary osteosarcoma. 105 65

A patient's immunologic response to a malignant tumor may be a major factor in determining his ultimate prognosis. An in vitro microcytotoxicity test using cultured tritiated thymidine (3HT) labeled osteosarcoma cells and autologous fibroblasts has been developed to determine the nature of this response. The role of cell mediated and serum factors has been quantitatively evaluated and the following results obtained. Osteosarcoma patients have been demonstrated to possess a normal cellular immune response which exhibits non-specific cytotoxicity in vitro. These patients can not differentiate their tumor cells from autologous fibroblasts, even though they may significantly suppress the growth of homologous tumors or fibroblasts. Serum blocking factors capable of inhibiting lymphocyte mediated cytotoxicity are occasionally noted. A reliable quantitative microcytotoxicity technique is presented which demonstrates that: (1) osteosarcoma is not due to host immuno-incompetence, (2) a common sarcoma antigen does not exist and (3) serum blocking factors may occasionally be present.
Clin Orthop Relat Res 1975 Sep
PMID:The host immune response in human osteosarcoma. 105 66

The treatment of patients with osteosarcoma continues to result in few survivors despite advances in surgery and radiotherapy. Since the primary site of failure is pulmonary, it is apparent that a systemically active adjuvant must be employed if a cure is to be achieved. Because of the experimental evidence for an immune response against osteosarcoma and because of the potential systemic activity of the immune system, a trial of postoperative adjuvant immunotherapy was begun. Seventeen patients received immunotherapy consisting of BCG and an allogeneic tumor cell vaccine following surgical removal of all gross tumors. Eighteen per cent (3/17) of the patients who received immunotherapy remained alive and free of disease compared to 0/12 who did not. An analysis of the 14 patients with recurrence, revealed that the median time to recurrence was 3.0 months in both groups. It is, therefore, apparent that at the time of initiation of immunotherapy subclinical metastasis must already have been present. Therefore, on the basis of this study we conclude that adjuvant chemotherapy should be employed to further reduce the tumor cell burden in order for immunotherapy to be effective for osteosarcoma.
Clin Orthop Relat Res 1975 Sep
PMID:Osteosarcoma. Results of treatment employing adjuvant immunotherapy. 105 67

The present study was undertaken to explore the relationship of the time interval between application of heat and irradiation on enhanced tumor cell sensitivity. Using the Ridgway osteogenic sarcoma grown in AKD2F1/J mice, local tumor hyperthermia (42.5 +/- .5 degrees C for 15 minutes) was applied at various time intervals before or after single or fractionated doses of x irradiation. Enhancement of tumor cell sensitivity by combined treatment with radiation and heat, as measured by delay in tumor growth, cure rates, and mean survival times was inversely proportional to the time interval between application of both modalities. The interactions associated with this increased sensitivity appear to be transitory, diminishing with time between treatments. Possible mechanisms of action for thermal sensitization may involve the reduction of oxygen dependence as well as a reduced recovery capacity of tumor cells.
Cancer 1975 Sep
PMID:The relationship between the time of fractionated and single doses of radiation and hyperthermia on the sensitization of an in vivo mouse tumor. 105 37

Immunological studies are presented on a patient with a long clinical history suggesting the existence of a tumor-specific immune response. His tumor, first considered benign, progressed to a highly malignant osteosarcoma. Cell-mediated immune reactivity against biopsy cells and against tumor extract was detected in vitro by the autologous tumor stimulation test (ATS) and in vivo by the skin test. In one ATS-test with tumor extract, blastogenesis of T-cells was demonstrated. The amount of Ig(s) in consecutive biopsies increased. Biopsies taken in the later period of the disease stimulated only after trypsin treatment. This stimulation was inhibited by autologous serum or acid eluate of the biopsy. The inhibitory factor in the serum was not intact immunoglobin. Blood lymphocytes did not show a discriminatory or disease-related cytotoxicity, either directly or after co-cultivation with the tumor material. Lymphocytes isolated from one biopsy were non-reactive in both the ATS and the cytotoxicity test.
Int J Cancer 1976 Sep 15
PMID:Search for anti-tumor response in a bone tumor patient with a long clinical history. 106 20

In recent years, cytostatic chemotherapy has been added to the treatment of primary malignant bone tumors. Long-term results are not yet available. Since many of these tumors metastasize through the blood stream, the prognosis has been poor. Now a general improvement in the total number of cures is expected. In osteogenic sarcoma, amputation or exarticulation of the involved extremities is most frequently suggested; one can, however, continue to use preoperative radiotherapy. After 3 or at the most 6 months, amputation is carried out if the patient is free of metastases. Adjuvant chemotherapy should be carried out in every case. The side effects in the irradiated area, however, are considerably increased and, as a result, immediate amputation will become more and more popular. Irradiation of the primary tumor plays a decisive role in Ewing's sarcoma, surgical removal of the tumor does not require radicality at all costs. In reticulosarcoma of the bone, surgical intervention is limited to a biopsy because of high radiosensitivity. Adjuvant chemotherapy should be carried out in every case since a generalization is to be expected in 30% of the patients. The indications for "prophylactic" radiotherapy of the lung and the neurocranium were discussed.
Rontgenblatter 1976 Sep
PMID:[Radiation therapy and chemotherapy of primary malignant tumors of the bone (author's transl)]. 106

The survival times in a control series of 145 cases of osteogenic sarcoma without pulmonary resections including records of pulmonary nodules and surgical wedge excisions, suggest that pulmonary resection is a noteworthy adjunct treatment. The 5-year survival of patients subjected to repeated pulmonary surgery is known for 22 patients who were under the age of 21. Where aggressive pulmonary resections were performed, i.e., repeated thoracotomies, and multiple wedge resections of nodules, a 5-year survival rate of 31 per cent (after date of primary amputation) is noted and compared to a previous study of 145 cases, 121 of which had untreated pulmonary metastases, and at 5 years, only 2 per cent of these patients with metastases were still alive. Lung wedge resection survivals are highly significant statistically although survival with residual disease must be considered in part at least, due to aggressive chemotherapy (i.e., high dose methotrexate with citrovorum rescue in combination with other drugs).
Clin Orthop Relat Res 1975 Sep
PMID:The treatment of pulmonary metastasis in osteogenic sarcoma. 108 Apr 53

Tumor-associated antigen was found by reacting sera from two patients with giant cell tumor of bone with cells derived from their tumors, using autologous serum as intermediate reactant and fluorescein-conjugated goat anti-human IgG as final reactant. Approximately 40% of the plump, spindle-shaped cells that formed the background stroma of these tumors possessed the antigen; however, it was not present on giant cells. Fluorescence was much greater than that on similarly stained cells from 4 osteogenic sarcomas, suggesting that the antigenic density on cells from giant cell tumor was greater than that on cells from osteogenic sarcoma. Antibodies in sera from giant cell tumor patients and osteogenic sarcoma patients showed specific cross-reactivity. Stromal cells of giant cell tumors were established in culture and retained tumor-associated antigen, whereas giant cells failed to divide and detached from the flask within two weeks. Intensity of fluorescence (antigenic density) decreased with progressive passage levels, but a larger percentage of cells showed fluorescence. At the tenth passage, all cells bore tumor-associated antigen. Cultured cells that were injected s.c. into mice formed progressively growing nodules, the cells of which were morphologically indistinguishable from stromal cells of the original tumor; all cells retained tumor-associated antigen, but antigenic density had decreased to about one-seventh of the value found originally. No giant cells were present in the nodules.
Cancer Res 1975 Sep
PMID:Quantitative immunofluorescence studies of the tumor antigen-bearing cell in giant cell tumor of bone and osteogenic sarcoma. 109 9

Radiation therapy in the treatment of osteosarcoma has been considered with respect of the subclinical metastatic disease in the lung and the primary lesion. Emphasis is given to the necessity of coordinating the management plan of the primary lesion with an adjuvant program. Evaluation of the efficacy of a conservative treatment of the primary lesion by radiation therapy and chemotherapy is considered a proper subject for clinical study. A proper biopsy technique and several practical aspects of technique of radiation therapy in management of osteosarcomas of bone are important factors in survival time of individual patients.
Clin Orthop Relat Res 1975 Sep
PMID:Radiotherapy in osteosarcoma. 109 30


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>