Radiology, Vol 125, 497-502, Copyright © 1977 by Radiological Society of North America
Combined therapy of osteosarcoma: preoperative irradiation, surgery, and chemotherapy
JE Munzenrider, B Emami, I Tchakarova, TF Necheles, HH Banks, JC Paradelo and WH Oh
The rationale for prebiopsy and preoperative irradiation in a multimodal
approach to treatment of osteosarcoma is presented. Six patients with
osteosarcoma underwent preoperative irradiation, amputation, and elective
chemotherapy. Five of these also received prebiopsy irradiation: three
survive without metastases at 29, 36, and 56 months, with no therapy for
10, 16, and 37 months, respectively; two patients died at 6 and 19 months
of pulmonary metastases which appeared at 2 and 10 months, respectively.
The latter two did not receive prebiopsy irradiation. Another patient,
whose pulmonary metastasis regressed at 6 months with adriamycin and was
later resected, died of cardiac failure at 59 months without evident
metastasis. Immunologic aspects of the disease are also discussed.
