[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.
Delépine
Nicole
N
Unité d'Oncologie Pédiatrique et de l'Adulte Jeune, Hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny Cedex. nicole.delepine@wanadoo.fr
Alkallaf
Salwa
S
Cornille
Hélène
H
Markowska
Barbara
B
Delépine
Gérard
G
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