Effect of preoperative chemotherapy by intraarterial infusion of cisplatin (cis-dichlorodiammineplatin) on primary osteosarcomas.
Preoperative chemotherapy was conducted in seven cases of osteosarcoma by twice administering intraarterial infusions of cisplatin (100 mg/m2/day) and the effects were studied through evaluations of clinical symptoms, plane radiograms, angiographic findings, serum alkaline phosphatase levels determined prior to and after the intraarterial infusion, and the rate of necrosis of tumor cells in the resected material. Results of treatment were as follows: disappearance of pain in two cases; reduction of pain in five cases; reduction in tumor size in three cases; and an increase in tumor size in one case. Radiograms obtained after treatment showed a reduction of tumor shadow at the extraskeletal site in one case; no change in five cases; an increase in one case, a clearly defined lesion border in one case; and no change in six cases. The radiograms showed no significant change in many cases, but this is perhaps because the radiograms were taken only four weeks after the start of treatment. Angiograms obtained after the preoperative chemotherapy revealed the disappearance of neovascularity in neoplasms in three cases, reduction in two cases, and no change in two cases. Reductions in the rates of serum alkaline phosphatase levels were in the range of 8.3 to 93% (average, 47.8%); the rates of necrosis of the tumor cells in the resected materials were ranged from 53 to 95% (average, 82.1%). The present chemotherapy resulted in formation of a fibrous connective tissue in the reactive zone and in increase in thickness of its pseudo-capsule. From this, it may be said that, if a tumor is to be resected in the area a few of more centimeters distant from the newly formed tissue, the surgery can be conducted within a wide curative margin, or a safer surgical margin. Results obtained from an overall evaluation of the effects showed the chemotherapy to be markedly effective in one case, effective in four cases, slightly effective in one case, and to have no effect in one case. For making life prognostic evaluations, more case data and longer-range follow-up observations will be needed.
Suda
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D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D012516:Osteosarcoma / Q000188:drug therapy* / Q000601:surgery
D002945:Cisplatin