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Journal of Cancer Research and Clinical Oncology logoLink to Journal of Cancer Research and Clinical Oncology
. 1983 Jan;106(Suppl 1):55–67. doi: 10.1007/BF00625054

Primary osteogenic sarcoma: Eight-year experience with adjuvant chemotherapy

Gerald Rosen 1,2,, Ralph C Marcove 3, Andrew G Huvos 4, Brenda I Caparros 1, Joseph M Lane 3, Anita Nirenberg 1,5, Adrienne Cacavio 5, Susan Groshen 6
PMCID: PMC12252329  PMID: 6604058

Abstract

Since October 1973, 185 patients 21 years of age or younger with primary osteogenic sarcoma of an extremity were treated with adjuvant chemotherapy. Twenty-five of the first fifty-two patients (48%) have remained free of disease for a median of 7 years. In the next chemotherapy protocol most patients had chemotherapy prior to amputation or resection, during which time the dose of high-dose methotrexate was escalated in many patients to that needed to shrink the primary tumor. For a median of 4 years 43 of 54 patients (80%) have remained free of disease. In the current protocol, the response of the primary tumor to chemotherapy with high-dose methotrexate was used to select postoperative adjuvant chemotherapy for the patient. With the latter approach 73 of 79 patients (92%) have remained continuously free of disease for a median of 2 years. This experience demonstrates the value of chemotherapy in increasing the cure rate in osteogenic sarcoma and that the response to preoperative chemotherapy can help select postoperative chemotherapy to produce an even higher potential cure rate for osteogenic sarcoma.

Key words: Osteogenic sarcoma, Chemotherapy, Hig-dose methotrexate

Footnotes

Supported by NCI-CCRC grant CA-05826-18

References

  • 1.Allen JC, Rosen G, Mehta B, Horten B (1980) Leukoencephalopathy following high dose I. V. methotrexate chemotherapy with leucovorin rescue. Cancer Treat Rep 64:1261–1273 [PubMed] [Google Scholar]
  • 2.Burchenal J (1975) From wild fowl to stalking horses: Alchemy in chemotherapy. Cancer 35:1121–1135 [DOI] [PubMed] [Google Scholar]
  • 3.Catane R, Bono VH, Louie AC (1978) High-dose methotrexate, not a conventional treatment. Cancer Treat Rep 62:178–180 [PubMed] [Google Scholar]
  • 4.Cortes EP, Holland JF, Wang JJ (1975) Adriamycin (NSC-123127) in 87 patients with osteogenic sarcoma. Cancer Chemother Rep (part 3) 6:305–313 [Google Scholar]
  • 5.Etcubanas E, Wilbur JR (1978) Adjuvant chemotherapy for osteogenic sarcoma. Cancer Treat Rep 62:283–287 [PubMed] [Google Scholar]
  • 6.Fossati-Bellani F, Gasparini M, Gennari L (1978) Adjuvant treatment with adriamycin in primary operable osteosarcoma. Cancer Treat Rep 62:289–294 [PubMed] [Google Scholar]
  • 7.Friedman MA, Carter SK (1972) The therapy of osteogenic sarcoma. Current status and thoughts for the future. J Surg Oncol 4:482–510 [DOI] [PubMed] [Google Scholar]
  • 8.Jaffe N (1972) Recent advances in the chemotherapy of metastatic osteogenic sarcoma. Cancer 30:1627–1631 [DOI] [PubMed] [Google Scholar]
  • 9.Jaffe N, Frei E, Traggis D (1977) Weekly high-dose methotrexate-citrovorum factor in osteogenic sarcoma. Cancer 39:45–50 [DOI] [PubMed] [Google Scholar]
  • 10.Marcove RC, Mike V, Hajek JV (1970) Osteogenic sarcoma under the age of 21. A review of 145 operative cases. J Bone Joint Surg [Am] 52:411–423 [PubMed] [Google Scholar]
  • 11.Marcove RC, Mike V, Hajek JV (1977) Osteogenic sarcoma in childhood. New York State J Med 71:855–859 [PubMed] [Google Scholar]
  • 12.Marcove RC (1977) En bloc resection for osteogenic sarcoma. Can J Surg 20:521–528 [PubMed] [Google Scholar]
  • 13.Marcove RC, Lewis MM, Huvos AG (1977) En bloc upper humeral interscapulo-thoracic resection. The Tikhoff-Linberg procedure. Clin Orthop 124:219–228 [PubMed] [Google Scholar]
  • 14.Mehta BM, Juergens H, Allen JC (1980) Distribution of methotrexate, citrovorum factor, and 5-methyltetrahydrofolate after high-dose methotrexate-leucovorin recue in osteogenic sarcoma. In: Nelson JD, Grassi C (eds) Current chemo-therapy and infectious disease. Proceedings of the 11th International Congress of Chemotherapy and the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington D.C. (vol 22, pp 1535–1636)
  • 15.Mosende C, Guttierez M, Caparros B (1977) Combination chemotherapy with bleomycin, cyclophosphamide and dactinomycin for the treatment of osteogenic sarcoma. Cancer 40:2779–2786 [DOI] [PubMed] [Google Scholar]
  • 16.Nirenberg A, Mosende C, Mehta BM (1977) High dose methotrexate with citrovorum factor rescue: Predictive value of serum methotrexate concentrations and corrective measures to avert toxicity. Cancer Treat Rep 61:779–783 [PubMed] [Google Scholar]
  • 17.Ochs JJ, Freeman AI, Douglass HO (1978) Cis-dichlorodiammine-platinum (II) in advanced osteogenic sarcoma. Cancer Treat Rep 62:239–245 [PubMed] [Google Scholar]
  • 18.Pratt CB, Howarth C, Ranson JL (1980) High-dose methotrexate alone and in combination therapy for measurable primary or metastatic osteosarcoma. Cancer Treat Rep 64:11–20 [PubMed] [Google Scholar]
  • 19.Pratt CB (1980) Chemotherapy of osteosarcoma. An overview. In: Van Oosterom AT, Muggia FM, Cleton FJ (eds) Therapeutic progress in ovarian cancer, testicular cancer and the sarcomas. Martinus Nijhoff, The Hague (pp. 329–348) [Google Scholar]
  • 20.Pratt CB, Shanks EC, Hustu HO (1977) Adjuvant multiple drug chemotherapy for osteogenic sarcoma of the extremity. Cancer 39:51–57 [DOI] [PubMed] [Google Scholar]
  • 21.Rosen G, Murphy ML, Huvos AG (1976) Chemotherapy, en bloc resection and prosthetic bone replacement in the treatment of osteogenic sarcoma. Cancer 37:1–11 [DOI] [PubMed] [Google Scholar]
  • 22.Rosen G, Huvos AG, Mosende C (1978) Chemotherapy and thoracotomy for metastatic osteogenic sarcoma. A model for adjuvant chemotherapy and the rationale for the timing of thoracic surgery. Cancer 41:841–849 [DOI] [PubMed] [Google Scholar]
  • 23.Rosen G, Nirenberg A, Juergens H (1980) Response of primary osteogenic sarcoma to single-agent therapy with high-dose methotrexate und citrovorum factor rescue. In: Nelson JD, Grassi C (eds) Current chemotherapy and infectious disease. Proceedings of the 11th International Congress of Chemotherapy and the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington D.C. (vol. 2, pp. 1633–1635)
  • 24.Rosen G, Marcove RC, Caparros B (1979) Primary osteogenic sarcoma. The rationale for preoperative chemotherapy and delayed surgery. Cancer 43:2163–2177 [DOI] [PubMed] [Google Scholar]
  • 25.Rosen G, Nirenberg A, Juergens H (1979) Phase II trial of cisplatinum in osteogenic sarcoma. Proc Am Assoc Cancer Res 20:363 [Google Scholar]
  • 26.Rosen G, Suvanisirikul S, Kwon C (1974) High-dose Methotrexate with citrovorum factor rescue and adriamycin in childhood osteogenic sarcoma. Cancer 33:1151–1163 [DOI] [PubMed] [Google Scholar]
  • 27.Rosen G, Caparros B, Huvos AG (1982) Preoperative chemotherapy for osteogenic sarcoma: Selection of postoperative adjuvant chemotherapy based upon the response of the primary tumor to preoperative chemotherapy. Cancer 49:1221–1230 [DOI] [PubMed] [Google Scholar]
  • 28.Rosenberg SA, Chabner BA, Young RC (1979) Treatment of osteogenic sarcoma. Effect of adjuvant high-dose Methotrexate after amputation. Cancer Treat Rep 63:739–751 [PubMed] [Google Scholar]
  • 29.Rosenberg SA, Flye MW, Conkle D (1979) Treatment of osteogenic sarcoma. Aggressive resection of pulmonary metastases. Cancer Treat Rep 63:753–756 [PubMed] [Google Scholar]
  • 30.Salzer M, Knahr K, Kotz R, Kristen H (1981) Treatment of osteosarcomata of the distal femur by rotation-plasty. Arch Orthop Traumat Surg 99:131–136 [DOI] [PubMed] [Google Scholar]
  • 31.Sutow WW, Vietti TJ, Fernbach DJ (1971) Evaluation of chemotherapy in children with metastatic Ewing's sarcoma and osteogenic sarcoma. Cancer Chemother Rep 55:67–81 [PubMed] [Google Scholar]
  • 32.Sutow WW, Gehan EA, Dyment PA (1978) Multi-drug adjuvant chemotherapy for osteosarcoma. Interim Report of the Southwest Oncology Group Studies. Cancer Treat Rep 62:265–270 [PubMed] [Google Scholar]
  • 33.Sutow WW, Sullivan MP, Milbur JR (1975) A study of adjuvant chemotherapy in osteogenic sarcoma. J Clin Pharmacol 7:530–533 [DOI] [PubMed] [Google Scholar]
  • 34.Van Ness CP (1950) Rotationplasty in the treatment of congenital defects of the femur. J Bone Joint Surg [Br] 32:12 [Google Scholar]
  • 35.Weinfeld MS, Dudley HR (1962) Osteogenic sarcoma. A followup study of 94 cases observed at the Massachusetts General Hospital from 1920 to 1960. J Bone Joint Surg [Am] 44:269–276 [PubMed] [Google Scholar]

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