[Progress and stagnation in chemotherapy protocols for primary osteosarcoma].
Thirty years ago, osteosarcoma of a limb meant amputation and death. Two years after diagnosis, 80% of the patients died from pulmonary metastases, despite early amputation. In 2002, more than 70% of these patients can be cured. Successful cure requires adequate and early management centered on en-bloc resection by a specialized surgeon, followed by a long, expensive, and adapted chemotherapy. The cornerstone is high-dose methotrexate. We present data accumulated over the last 30 years on the treatment of osteosarcoma and point out the fundamental steps of this success story.
Unité d'Oncologie Pédiatrique et de l'Adulte Jeune, Hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny Cedex. nicole.delepine@wanadoo.fr
Nicole
N
Delépine
Salwa
S
Alkallaf
Hélène
H
Cornille
Barbara
B
Markowska
Gérard
G
Delépine
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate