Management of osteogenic sarcoma patients
作者:
N. N. Trapeznikov,
L. A. Yerimina,
A. T. Amirasianov,
P. A. Sinukov,
期刊:
Seminars in Surgical Oncology
(WILEY Available online 1986)
卷期:
Volume 2,
issue 1
页码: 1-16
ISSN:8756-0437
年代: 1986
DOI:10.1002/ssu.2980020102
出版商: John Wiley&Sons, Inc.
关键词: osteogenic sarcoma;surgical treatment;adjuvant chemotherapy;free of disease survival rate;prognosis;pulmonary metastases
数据来源: WILEY
摘要:
AbstractThe experience in the management of 246 patients with local osteogenic sarcoma and 67 patients with pulmonary metastases in the All‐Union Oncologic Research Center, AMS USSR, is presented here. All the patients underwent surgery, but starting in 1974, various modalities of adjuvant chemotherapy (not randomized) were applied in addition. In the surgery alone group, prognosis was very poor: only 7.0% of patients survived free of disease 5 years from the primary tumor treatment. Adjuvant chemotherapy (adriamycin + vincristine + melphalan + cyclo‐phosphamide) following amputations increased this rate to 34.0%; combining segmental resections of an affected bone with preoperative intraarterial adriamycin infusion and radiation (36 Gy) increased the rate to 35.5%. In patients with grade 4 tumor damage (tumor cells are not found upon examination of a large number of sections), the rate increased to 57.9% (P<.05). Another regimen of adjuvant chemotherapy (plati‐diam or cisplatin + adriamycin + cyclophosphamide) gives a chance to 78.8% of patients to survive 1 year free of metastases. The same chemotherapy regimen enables us to achieve an objective effect in 30.8% of patients with pulmonary metastases, and its combination with surgical metastasis ablation makes it possible to obtain a complete remission, lasting from 2 to 46 months (average 13.9 months). Toxic manifestations of the chemotherapy regimens considered are moderate. Prognosis in adjuvant chemotherapy is related to age, tumor site, its local dissemination, and morphologic type of osteogenic sa
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