[Scintigraphic follow-up of osteosarcoma during neoadjuvant chemotherapy. Results of the cooperative osteosarcoma study of the Society for Pediatric Oncology].
The response of osteosarcomas to preoperative chemotherapy as measured by quantitative 99mTc-diphosphonate scintigraphy was compared with the amount of tumor cell destruction found histologically in the resected specimens. 3-phase bone scintigraphy, with determination of tumor/non-tumor (T/NT) ratios, allowed accurate prediction of tumor response in 28 of 30 tumors (accuracy = 93%) after completion and in 10 of 12 osteosarcomas (83%) at the half-way stage of preoperative chemotherapy, when only those tumors were evaluated which showed convergent changes of T/NT ratios in the perfusion and the mineral phase. At the half-way stage, however, evaluation of chemotherapy effects was complicated in 12 of 23 osteosarcomas by diverging T/NT ratios. In contrast, quantification and mapping of the tumor plasma volume and 99mTc-diphosphonate clearance on parametric images predicted correctly the histological tumor response to chemotherapy in 10 of 11 tumors (91%) after completion and in all 11 cases (100%) at the half-way stage.
Bielack
S
S
Universitätskinderklinik, Abt. Hämatologie und Onkologie, Hamburg-Eppendorf, BRD.
Knop
J
J
Delling
G
G
Winkler
K
K
D000293:Adolescent; D000328:Adult; D006585:Altretamine / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
D000970:Antineoplastic Agents; D001761:Bleomycin; D003609:Dactinomycin; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D006585:Altretamine; D013669:Technetium Tc 99m Medronate; D008727:Methotrexate
Szintigraphische Verlaufskontrolle von Osteosarkomen während neoadjuvanter Chemotherapie. Ergebnisse der kooperativen Osteosarkomstudie COSS der Gesellschaft für Pädiatrische Onkologie.