title: Neoadjuvant chemotherapy in the treatment of osteosarcoma of the extremities: preliminary results in 131 cases treated preoperatively with methotrexate and cisdiamminoplatinum.
abstract: The results of 131 cases of classic non-metastatic osteosarcoma of the extremities treated with preoperative chemotherapy, surgery and postoperative chemotherapy are reported. Preoperatively, the patients were given Methotrexate (MTX) intravenously (high and average doses) and Cisplatinum (CDP) intraarterially. For postoperative chemotherapy, the drugs and treatment protocols were based on the degree of necrosis observed (good, fair, poor). Conservative surgery was performed in 73% of the cases and amputation in 27%. At an average 30 month follow-up (9-48 months) 59.5% of the patients had remained disease-free, 37.5% had developed metastases, and 3% had developed local recurrence. The percentage of disease-free patients was higher for those treated with high doses of MTX (68% vs. 51%) and for those in whom preoperative chemotherapy had induced good necrosis (75% vs. 44%). Neither the age or sex of the patients, nor the site of the tumor or type of surgery performed influenced prognosis.
authors.affiliation: Servizio Medicina Interna, Istituto Ortopedico Rizzoli, Bologna.
authors.forename: G
authors.initials: G
authors.lastname: Bacci
authors.forename: M
authors.initials: M
authors.lastname: Avella
authors.forename: R
authors.initials: R
authors.lastname: Capanna
authors.forename: S
authors.initials: S
authors.lastname: Boriani
authors.forename: D
authors.initials: D
authors.lastname: Dallari
authors.forename: S
authors.initials: S
authors.lastname: Galletti
authors.forename: A
authors.initials: A
authors.lastname: Giunti
authors.forename: E
authors.initials: E
authors.lastname: Madon
authors.forename: A
authors.initials: A
authors.lastname: Mancini
authors.forename: M
authors.initials: M
authors.lastname: Mercuri
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000188:drug therapy* / Q000601:surgery; D011379:Prognosis; D011897:Random Allocation; D013997:Time Factors
chemical_list: D002945:Cisplatin; D008727:Methotrexate