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Erschienen in: Medical Oncology 4/2011

01.12.2011 | Original Paper

Chemoradiotherapy in the treatment of inoperable high-grade osteosarcoma

verfasst von: Micaela M. Hernberg, Aarne H. Kivioja, Tom O. Böhling, Rita J. Janes, Tom A. Wiklund

Erschienen in: Medical Oncology | Ausgabe 4/2011

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Abstract

Radical surgery is not feasible for all osteosarcoma patients. Overall survival for non-extremity osteosarcoma, as well as for patients with metastatic disease at diagnosis remains poor. For such patients, radical radiotherapy combined with chemotherapy may present an effective treatment approach. This report describes the results of conservative treatment for osteosarcoma patients not suitable for surgery. Seven out of 71 consecutive osteosarcoma patients were treated non-surgically at the Helsinki University Central Hospital either due to the inoperability of the tumour or the patient’s choice of therapy. Staging procedures and measurement of tumour size were performed using computed tomography and magnetic resonance imaging. Six patients were treated with chemo-radiotherapy, and one patient received radiotherapy alone. Five patients received computer-assisted dose-planned radiotherapy with curative intent (total dose 60–70.5 Gray), and two patients received radiotherapy as palliation. Radiotherapy relieved symptoms efficiently. Median time to local failure was 2.6 years (range 0.5–16.9+ years). Five year after treatment termination four patients were alive, and one of them remained disease-free. For selected patients not suitable for surgery, radiotherapy combined with chemotherapy provides an option to reduce symptoms caused by the primary tumour and improve quality of life. For some patients, this approach may (even) produce long-term remission.
Literatur
1.
Zurück zum Zitat Bacci G, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremity: long-term results of the Rizzoli’s 4th protocol. Eur J Cancer. 2001;37(16):2030–9.PubMedCrossRef Bacci G, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremity: long-term results of the Rizzoli’s 4th protocol. Eur J Cancer. 2001;37(16):2030–9.PubMedCrossRef
2.
Zurück zum Zitat Smeland S, et al. Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders. Eur J Cancer. 2003;39(4):488–94.PubMedCrossRef Smeland S, et al. Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders. Eur J Cancer. 2003;39(4):488–94.PubMedCrossRef
3.
Zurück zum Zitat Solheim OP, Saeter G, Elomaa I, Alvegard TA. The treatment of osteosarcoma: present trends. The Scandinavian Sarcoma Group experience. Ann Oncol. 1992;3(Suppl 2):S7–11.PubMed Solheim OP, Saeter G, Elomaa I, Alvegard TA. The treatment of osteosarcoma: present trends. The Scandinavian Sarcoma Group experience. Ann Oncol. 1992;3(Suppl 2):S7–11.PubMed
4.
Zurück zum Zitat Kager L, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol. 2003;21(10):2011–8.PubMedCrossRef Kager L, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol. 2003;21(10):2011–8.PubMedCrossRef
5.
Zurück zum Zitat Ozaki T, et al. Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group. J Clin Oncol. 2003;21(2):334–41.PubMedCrossRef Ozaki T, et al. Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group. J Clin Oncol. 2003;21(2):334–41.PubMedCrossRef
6.
Zurück zum Zitat Hundsdoerfer P, et al. Long-term outcome after polychemotherapy and intensive local radiation therapy of high-grade osteosarcoma. Eur J Cancer. 2009;45(14):2447–51.PubMedCrossRef Hundsdoerfer P, et al. Long-term outcome after polychemotherapy and intensive local radiation therapy of high-grade osteosarcoma. Eur J Cancer. 2009;45(14):2447–51.PubMedCrossRef
7.
Zurück zum Zitat Machak GN, et al. Neoadjuvant chemotherapy and local radiotherapy for high-grade osteosarcoma of the extremities. Mayo Clin Proc. 2003;78(2):147–55.PubMedCrossRef Machak GN, et al. Neoadjuvant chemotherapy and local radiotherapy for high-grade osteosarcoma of the extremities. Mayo Clin Proc. 2003;78(2):147–55.PubMedCrossRef
8.
Zurück zum Zitat DeLaney TF, et al. Radiotherapy for local control of osteosarcoma. Int J Radiat Oncol Biol Phys. 2005;61(2):492–8.PubMedCrossRef DeLaney TF, et al. Radiotherapy for local control of osteosarcoma. Int J Radiat Oncol Biol Phys. 2005;61(2):492–8.PubMedCrossRef
9.
Zurück zum Zitat Wagner TD, et al. Combination short-course preoperative irradiation, surgical resection, and reduced-field high-dose postoperative irradiation in the treatment of tumors involving the bone. Int J Radiat Oncol Biol Phys. 2009;73(1):259–66.PubMedCrossRef Wagner TD, et al. Combination short-course preoperative irradiation, surgical resection, and reduced-field high-dose postoperative irradiation in the treatment of tumors involving the bone. Int J Radiat Oncol Biol Phys. 2009;73(1):259–66.PubMedCrossRef
10.
Zurück zum Zitat Bacci G, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremities with metastases at presentation: recent experience at the Rizzoli Institute in 57 patients treated with cisplatin, doxorubicin, and a high dose of methotrexate and ifosfamide. Ann Oncol. 2003;14(7):1126–34.PubMedCrossRef Bacci G, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremities with metastases at presentation: recent experience at the Rizzoli Institute in 57 patients treated with cisplatin, doxorubicin, and a high dose of methotrexate and ifosfamide. Ann Oncol. 2003;14(7):1126–34.PubMedCrossRef
11.
Zurück zum Zitat Jaffe N, et al. Can cure in patients with osteosarcoma be achieved exclusively with chemotherapy and abrogation of surgery? Cancer. 2002;95(10):2202–10.PubMedCrossRef Jaffe N, et al. Can cure in patients with osteosarcoma be achieved exclusively with chemotherapy and abrogation of surgery? Cancer. 2002;95(10):2202–10.PubMedCrossRef
12.
Zurück zum Zitat Williams MV, Denekamp J, Fowler JF. A review of alpha/beta ratios for experimental tumors: implications for clinical studies of altered fractionation. Int J Radiat Oncol Biol Phys. 1985;11(1):87–96.PubMedCrossRef Williams MV, Denekamp J, Fowler JF. A review of alpha/beta ratios for experimental tumors: implications for clinical studies of altered fractionation. Int J Radiat Oncol Biol Phys. 1985;11(1):87–96.PubMedCrossRef
13.
Zurück zum Zitat Elomaa I, et al. Five-year results in Ewing’s sarcoma. The Scandinavian Sarcoma Group experience with the SSG IX protocol. Eur J Cancer. 2000;36(7):875–80.PubMedCrossRef Elomaa I, et al. Five-year results in Ewing’s sarcoma. The Scandinavian Sarcoma Group experience with the SSG IX protocol. Eur J Cancer. 2000;36(7):875–80.PubMedCrossRef
14.
Zurück zum Zitat Bolek TW, et al. Local control and functional results after twice-daily radiotherapy for Ewing’s sarcoma of the extremities. Int J Radiat Oncol Biol Phys. 1996;35(4):687–92.PubMedCrossRef Bolek TW, et al. Local control and functional results after twice-daily radiotherapy for Ewing’s sarcoma of the extremities. Int J Radiat Oncol Biol Phys. 1996;35(4):687–92.PubMedCrossRef
15.
Zurück zum Zitat Le Pechoux C, et al. Postoperative radiotherapy in the management of adult soft tissue sarcoma of the extremities: results with two different total dose, fractionation, and overall treatment time schedules. Int J Radiat Oncol Biol Phys. 1999;44(4):879–86.PubMedCrossRef Le Pechoux C, et al. Postoperative radiotherapy in the management of adult soft tissue sarcoma of the extremities: results with two different total dose, fractionation, and overall treatment time schedules. Int J Radiat Oncol Biol Phys. 1999;44(4):879–86.PubMedCrossRef
16.
Zurück zum Zitat Mahajan A, et al. Multimodality treatment of osteosarcoma: radiation in a high-risk cohort. Pediatr Blood Cancer. 2008;50(5):976–82.PubMedCrossRef Mahajan A, et al. Multimodality treatment of osteosarcoma: radiation in a high-risk cohort. Pediatr Blood Cancer. 2008;50(5):976–82.PubMedCrossRef
Metadaten
Titel
Chemoradiotherapy in the treatment of inoperable high-grade osteosarcoma
verfasst von
Micaela M. Hernberg
Aarne H. Kivioja
Tom O. Böhling
Rita J. Janes
Tom A. Wiklund
Publikationsdatum
01.12.2011
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 4/2011
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-010-9592-2

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