Osteosarcoma: angiographic assessment of response to preoperative chemotherapy.
Adjuvant chemotherapy prolongs the survival of patients with high-grade osteosarcoma. Preoperative chemotherapy allows identification of effective agents for adjuvant chemotherapy based on response of the primary tumor. Preoperative determination of tumor response has therapeutic implications, and angiography offers a less subjective means of assessing it than do conventional radiography or computed tomography. Changes in tumor vascularity, as seen angiographically, after two courses and at the time of the last of several courses of preoperative chemotherapy were correlated with histologic tumor necrosis of resected specimens in 81 patients. Angiographically, 40% of the histologic responders and 91% of the nonresponders were identified after two courses of preoperative chemotherapy. After a median of four courses of chemotherapy, 91% of the responders but only 50% of the nonresponders were identified angiographically. Angiographic assessment of tumor vascularity, although not of absolute value, offers a useful guideline for determining the preoperative chemotherapy strategy.
Carrasco
C H
CH
Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Charnsangavej
C
C
Raymond
A K
AK
Richli
W R
WR
Wallace
S
S
Chawla
S P
SP
Ayala
A G
AG
Murray
J A
JA
Benjamin
R S
RS
D000328:Adult; D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011300:Preoperative Care; D012189:Retrospective Studies
D004317:Doxorubicin; D002945:Cisplatin