[Recent advances in management of musculoskeletal tumors].
Neoadjuvant chemotherapy plays a significant role in improving the prognosis of malignant bone tumors such as osteosarcoma and Ewing's sarcoma. Doxorubicin, cisplatin and high-dose methotrexate are key drugs in the chemotherapy for osteosarcoma. Intraarterial administration of the drugs is very effective in local control, so that wide resection of the tumor may be performed safely. The efficacy of preoperative chemotherapy is evaluated by the histological necrosis rate of the resected tumor after which postoperative drugs will be chosen. Limb salvage is becoming more and more common, and an excellent limb can be reconstructed using an artificial joint. In soft tissue sarcomas, brachytherapy can make the surgical resection margin narrower, resulting in good function of the extremities. Fragility of bone caused by metastatic bone diseases is reversed by surgical intervention.
Uchida
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Dept. of Orthopedic Surgery, Mie University School of Medicine.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D001918:Brachytherapy; D003131:Combined Modality Therapy; D006801:Humans; D007595:Joint Prosthesis; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000188:drug therapy; D019651:Plastic Surgery Procedures; D012512:Sarcoma, Ewing / Q000188:drug therapy; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*