title: [Standards and Options for the use of radiation therapy  in the management of patients with osteosarcoma. Update 2004].
abstract: BACKGROUND
  The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French regional cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.
  
  
  OBJECTIVE
  To update the SOR recommendations for the use of radiation therapy in the management of patients with osteosarcoma. This work was performed in collaboration with the French society against cancers in children and adolescent (SFCE).
  
  
  METHODS
  Data have been identified by literature search using Medline (from January 1992 to October 2003). In addition several Internet sites were searched in October 2003.
  
  
  RESULTS
  The 3 mains standards are: 1) local and exclusive curative irradiation is not indicated as primary treatment for osteosarcoma or for local and operable recurrence, except for lesion in inaccessible sites or if the patient refuses surgery; 2) local and prophylactic adjuvant irradiation is not indicated for the treatment of osteosarcoma after chemotherapy (neoadjuvant and/or adjuvant) and complete macro or microscopic surgery, except for non-operable R1 or R2 surgical resection; 3) whole-lung prophylactic irradiation is not indicated in non-metastatic osteosarcoma. Systemic metabolic radiotherapy for pain treatment, using samarium-153 ethylenediaminetetramethylene phosphonic acid (Sm-153-EDTMP) can be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation).
authors.affiliation: Centre Léon-Bérard, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Claude
authors.forename: S
authors.initials: S
authors.lastname: Rousmans
authors.forename: C
authors.initials: C
authors.lastname: Carrie
authors.forename: N
authors.initials: N
authors.lastname: Breteau
authors.forename: F
authors.initials: F
authors.lastname: Dijoud
authors.forename: J C
authors.initials: JC
authors.lastname: Gentet
authors.forename: F
authors.initials: F
authors.lastname: Giammarile
authors.forename: J L
authors.initials: JL
authors.lastname: Jouve
authors.forename: M
authors.initials: M
authors.lastname: Kind
authors.forename: P
authors.initials: P
authors.lastname: Marec-Bérard
authors.forename: E
authors.initials: E
authors.lastname: Mascard
authors.forename: A
authors.initials: A
authors.lastname: Bataillard
authors.forename: T
authors.initials: T
authors.lastname: Philip
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D008168:Lung / Q000528:radiation effects; D008175:Lung Neoplasms / Q000517:prevention & control / Q000556:secondary; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D011446:Prospective Studies; D011787:Quality of Health Care; D011868:Radioisotopes / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012493:Samarium / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011868:Radioisotopes; D012493:Samarium