BACKGROUND: Current standard therapy for high-grade osteosarcoma is neoadjuvant chemotherapy and complete resection of the primary tumour. Irradiation can improve local control if complete tumour resection is not possible or refused, but data on long-term outcome are not available. PATIENTS AND METHODS: We report on long-term results for overall survival, occurrence of local recurrence and metastasis, joint function and side-effects in 13 patients with high-grade osteosarcoma having been treated with a combination of local irradiation and polychemotherapy (median follow-up of 13.5 years). RESULTS: Ten of the 13 patients were alive 4-23 years after diagnosis. Three patients suffered local recurrence, in 2 of them tumour control and long-term survival could be achieved by secondary salvage surgery and polychemotherapy. In 5 patients pathological fractures of the irradiated bones occurred, none of them was associated with local recurrence. In 7 of the 10 long-term survivors good or fair joint function was achieved. CONCLUSIONS: We conclude that combination of chemotherapy and intensive local irradiation can achieve long-term local control and even cure in high-grade osteosarcoma. Thus radiation therapy may represent an alternative to definite surgery in selected patients, in particular in those with good response to chemotherapy, when surgery is not feasible or refused.
BACKGROUND: Current standard therapy for high-grade osteosarcoma is neoadjuvant chemotherapy and complete resection of the primary tumour. Irradiation can improve local control if complete tumour resection is not possible or refused, but data on long-term outcome are not available. PATIENTS AND METHODS: We report on long-term results for overall survival, occurrence of local recurrence and metastasis, joint function and side-effects in 13 patients with high-grade osteosarcoma having been treated with a combination of local irradiation and polychemotherapy (median follow-up of 13.5 years). RESULTS: Ten of the 13 patients were alive 4-23 years after diagnosis. Three patients suffered local recurrence, in 2 of them tumour control and long-term survival could be achieved by secondary salvage surgery and polychemotherapy. In 5 patients pathological fractures of the irradiated bones occurred, none of them was associated with local recurrence. In 7 of the 10 long-term survivors good or fair joint function was achieved. CONCLUSIONS: We conclude that combination of chemotherapy and intensive local irradiation can achieve long-term local control and even cure in high-grade osteosarcoma. Thus radiation therapy may represent an alternative to definite surgery in selected patients, in particular in those with good response to chemotherapy, when surgery is not feasible or refused.
Authors: Alessandra Longhi; Costantino Errani; Marco Gambarotti; Christina Ferrari; Jennifer Kreshak; Georgios N Panagopoulos; Andreas F Mavrogenis; Davide Donati Journal: Eur J Orthop Surg Traumatol Date: 2015-07-15
Authors: C Blattmann; M Thiemann; A Stenzinger; A Christmann; E Roth; V Ehemann; J Debus; A E Kulozik; W Weichert; P E Huber; S Oertel; A Abdollahi Journal: Strahlenther Onkol Date: 2013-06-27 Impact factor: 3.621
Authors: A F Mavrogenis; G Rossi; G Altimari; T Calabrò; A Angelini; E Palmerini; E Rimondi; P Ruggieri Journal: Radiol Med Date: 2012-08-09 Impact factor: 3.469
Authors: Jantine PosthumaDeBoer; Thomas Würdinger; Harm C A Graat; Victor W van Beusechem; Marco N Helder; Barend J van Royen; Gertjan J L Kaspers Journal: BMC Cancer Date: 2011-04-29 Impact factor: 4.430
Authors: Claudia Blattmann; Susanne Oertel; Markus Thiemann; Anne Dittmar; Eva Roth; Andreas E Kulozik; Volker Ehemann; Wilko Weichert; Peter E Huber; Albrecht Stenzinger; Jürgen Debus Journal: Radiat Oncol Date: 2015-07-16 Impact factor: 3.481