Delaying surgery with chemotherapy for osteosarcoma of the extremities.
Osteosarcoma is the most frequent primary cancer of bone. When treated by surgery alone, it is almost invariably followed by metastatic dissemination and death. This dismal prognosis can be improved dramatically by including chemotherapy in an interdisciplinary regimen. Today, two-thirds of patients with localised extremity primaries can achieve long-term survival with such intensive multimodal therapy. This article provides a summary overview of current pharmacotherapy in osteosarcoma of the extremities, focussing on the approach of preoperative 'neoadjuvant' chemotherapy and thus, the potential benefits and pitfalls of delaying surgery. Prospective, multi-institutional trials are essential in guaranteeing that as many patients as possible can benefit from modern, efficacious interdisciplinary therapeutic regimens and that further progress can be made.
Bielack
Stefan S
SS
Universitätsklinikum Münster, Cooperative Osteosarkomstudiengruppe (COSS), Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Münster, Germany. coss@uni-muenster.de
Machatschek
Jan-Nicolas
JN
Flege
Silke
S
Jürgens
Heribert
H
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D005121:Extremities; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D012516:Osteosarcoma / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
D000970:Antineoplastic Agents