The treatment of osteosarcoma of the extremities: Twenty year's experience at the istituto ortopedico rizzoli

摘要: Twenty year's (1959-1979) experience in the treatment of osteosarcoma at Bone Tumor Center Istituto Ortopedico Rizzoli is presented. During this period 433 cases were recorded, but only 266 considered. All patients underwent surgery after 1970 whole-lung irradiation (1971), immunotherapy and chemotherapy (1972 onward) added as adjuvant therapies on a nonrandomized basis. In group treated with alone prognosis was very poor: 10% survived nine years or more diagnosis, an average disease-free interval 7.7 months survival time 13 months. Monolateral had negative results abandoned six cases. Adjuvant irradiated autologous tumor cells gave moderately positive 16 patients, by delaying appearance first metastases, therefore increasing survival. performed three different protocols: one protocol ADM two protocols using VCR + MTX (at medium dose) ADM, administered according to schedules. Superimposable obtained these regimens. With equal follow-up, percentage continuously significantly higher than that (P less 0.001). The who relapses showed prolonged (mean = 12.3 months) onset metastasis. caused virtually no morbidity deaths. Reference made advantages large homogeneous caseload deriving from single institution avoid preselection bias evaluate effectiveness new therapeutic approaches when patient randomization has not been employed.