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ABSTRACT: We analyzed the effectiveness of preoperative chemotherapy mainly with radiographic images in 9 patients with osteosarcoma, 5 patients with other malignant bone tumor and 14 patients with malignant soft tissue tumor. Judging from the application of preoperative to postoperative chemotherapy and outcome, its evaluation was useful in osteosarcoma and malignant soft tissue tumors. Changes in radiographic images by preoperative chemotherapy were the same in malignant bone and soft tissue tumors, but the reactivity of the latter was more evident. In malignant bone and soft tissue tumors, the effects of preoperative chemotherapy should be evaluated for the cases with resection of primary tumor. Malignant bone tumors excepting osteosarcoma also should be assessed through further accumulation of many more cases.
Gan to kagaku ryoho. Cancer & chemotherapy 05/1989; 16(4 Pt 2-3):1749-54.
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ABSTRACT: Adjuvant chemotherapy mainly with ADR performed in 117 patients (pts) with primary osteosarcoma of the extremity for the purpose of preventing pulmonary metastasis after radical ablative surgery. The mean follow-up period for 117 pts was 51.7 months (range: 3 to 137), for 53 survivors, 90.1 months (range: 60 to 137) and for 64 decreased, 20.5 months (range: 3 to 73). ADR was administered intravenously with 0.6-0.8 mg/kg/day for 3 consecutive days at monthly intervals after surgery until reaching 600 or 500 mg/m2 of the total cumulative dose. Five-year overall and disease-free survival rate of all pts was 50.2% and 39.4%, respectively. Thirty-seven pts (multi-drug group) with the combination of ADR and HDMTX had a higher survival rate (63.1% in 5-year overall survival rate and 47.8% in 5-year disease-free survival rate) than that of 80 pts with ADR alone (ADR group) (44.4% in 5-year overall survival rate and 35.6% in 5-year disease-free survival rate). Five-year survival rate for 65 pts administered the greater than 500 mg of ADR was 59.3% compared to 36.9% for 52 pts the less than 500 mg (p less than 0.05). In 65 pts administered the greater than 500 mg of ADR, 5-year survival rate (76.5%) of the multidrug group (17 pts) showed superiority to that 52.1%) of the ADR group (48 pts) (p less than 0.01). Even in the multi-drug group, 5-year survival rate (76.5%) of 17 pts administered the greater than 500 mg of ADR was higher than that (41.3%) of 20 pts given the less than 500 mg (p less than 0.01). Distant metastases were recognized at lung in 52 pts (lung group), lung + extrapulmonary organs in 14 (+ extragroup), and only extrapulmonary organs in 3 (extra group). Five-year survival rate of 66 pts with pulmonary metastasis was 17.1% and 21.2% in the lung group compared with 0% of the extra group (P less than 0.01). Five-year survival rate for 23 pts treated with thoracotomy was 43.5% compared to 2.6% for 43 without it (p less than 0.01).
Gan to kagaku ryoho. Cancer & chemotherapy 01/1989; 15(12):3245-51.
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K Furuse
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ABSTRACT: Prognostic factors of bone and soft tissue sarcomas were analyzed and common factors observed were the size of tumor, histological malignancy and metastasis. When these factors were viewed in advance of treatment, however, the prognosis of the sarcomas has definitely improved with chemotherapy and radical surgery of primary and metastatic lesions, combined and not combined with radiotherapy. Preoperative adjuvant chemotherapy now plays an important role in the whole strategic regimen of cancer treatment. Of various prognostic factors, the dominance of the sensitivity of each patient to preoperative adjuvant chemotherapy was indicated.
Gan to kagaku ryoho. Cancer & chemotherapy 08/1988; 15(7):2050-5.
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ABSTRACT: The rationale of preoperative chemotherapy for osteosarcoma requires: eradication of microscopic metastatic foci which have already occurred in many patients with osteosarcoma, determination of a more effective form of postoperative adjuvant chemotherapy and easier and safer limb-salvage procedures through clearer marginal definition with reduction of primary lesions. In this paper, chemotherapeutic effects on the 5-year survival rate were analyzed for 49 patients with primary non-metastatic osteosarcoma of the extremities treated with radical surgery. The efficacy of preoperative chemotherapy was assessed in 11 cases of osteosarcomas treated with systemic chemotherapy as a preliminary study. As to the 5-year cumulative survival rate, the systemic group (20 cases) showed a level of 56.7%, which was significantly higher (p less than 0.05) than the figure of 13.8% in a historical retrospective group (29 cases). In assessing the effective tumor response to preoperative chemotherapy, a close correlation between the tumor necrotic ratio and the ratio of decrease of serum alkaline phosphatase was revealed. Seven (63.6%) of 11 cases showed correlation of the tumor necrotic ratio with the ratio of decrease of serum alkaline phosphatase. The tumor necrotic ratios calculated were relatively definite (50-60%) in the CDDP group (3 cases), varied (10-70%) in the HDMTX group (4 cases), and low (less than 40%) in the ADR group (4 cases), regarded as a control group in further studies.
Gan to kagaku ryoho. Cancer & chemotherapy 06/1987; 14(5 Pt 2):1392-8.
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ABSTRACT: Preoperative adjuvant chemotherapy for skeletal and soft tissue sarcomas requires: (1) correct identification of the effective postoperative adjuvant chemotherapy, (2) eradication of any of the micrometastatic foci that may have already occurred in many of the patients with these sarcomas, (3) easier and safer limb-salvage procedure, being clearly defined, with shrinkage of the primary lesion. For this purpose, a preoperative adjuvant chemotherapy regimen making practical use of intra-arterial CDDP (cis-dichlorodiammineplatinum II) infusion is desired in multi-drug combined chemotherapeutic treatment, including HDMTX (high-dose methotrexate), ADR (adriamycin) and CDDP. In this paper, the clinical application of preoperative adjuvant chemotherapy to skeletal and soft tissue sarcomas with combination of HDMTX and CDDP is presented in the light of the observations of tumor response to these anticancer agents, and the possibility of to establishing a new preoperative adjuvant protocol is discussed.
Gan to kagaku ryoho. Cancer & chemotherapy 06/1985; 12(5):1031-48.
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ABSTRACT: The therapeutic results for osteosarcoma were very discouraging before 1970 in Japan despite many modes of treatment. In 1960, Miki introduced the regional perfusion technique into the treatment of osteosarcoma, and in 1963, Akaboshi pioneered the intraarterial infusion technique. By these methods, a five-year survival rate about 30% was achieved during the period from 1971 to 1976. In Japan, the five-year disease-free survival rate will soon exceed 50% thanks to intensive multi-drug adjuvant chemotherapy, considering the therapeutic results of 117 cases of JOOG treated during 6 years from 1975 to 1980 and 114 cases included in the Group Study of Osteosarcoma treated during 8 years from 1973 to 1981. In most cases, ablative surgery must still be considered the standard method of treatment. However, the importance of preoperative adjuvant chemotherapy is emphasized because limb-saving operations have become an increasingly common feature in the management of osteosarcoma as a result of the recent advances achieved by intensive multi-drug adjuvant chemotherapy.
Gan to kagaku ryoho. Cancer & chemotherapy 10/1984; 11(9):1746-56.
