role of neo-adjuvant chemotherapy in the treatment of osteosarcoma新辅助化疗治疗骨肉瘤的角色.pdf

Open Journal of Orthopedics, 2012, 2, 25-29 25 /10.4236/ojo.2012.22005 Published Online June 2012 (http://www.SciRP.org/journal/ojo) Role of Neo-Adjuvant Chemotherapy in the Treatment of Osteosarcoma 1 1 2 Ranadeb Bandyopadhyay , Arindam Mukherjee , Bishan Basu 1Department of Orthopaedics, Bankura Sammilani Medical College, Bankura, India; 2Department of Radiotherapy, Bankura Sammi- lani Medical College, Bankura, India. Email: ranadeb.b@ Received March 14th, 2012; revised April 18th, 2012; accepted May 6th, 2012 ABSTRACT Osteosarcoma is a tumour characterized by the production of osteoid by malignant cells. The incidence is approximately 1 to 3 million/year. The incidence is slightly higher in males. Onset can occur at any age; however, primary high grade osteosarcoma usually occurs in the second decade of life. Historically patients with osteosarcoma were treated with immediate wide or radical amputation. Despite the treatment, 80% patients with apparently isolated disease died of distant metastases. In recent years the number of patients with osteosarcoma of the limb treated by amputation + chemotherapy has increased. In our study, we divided the patients into two groups. One group (A) was treated with amputation + ad- juvant chemotherapy. The other group (B) was treated with neo-adjuvant chemotherapy + amputation followed by ad- juvant-chemotherapy. In our study, the margin negativity in post surgical specimen was significantly higher (P-value 0.0007) for the group treated with neo-adjuvant chemotherapy. Local recurrence in the group treated without neoadju- vant chemotherapy was significantly more (P-value 0.0005). The systemic recurrence at the end of 6 months was higher the group treated without neoadjuvant chemotherapy (P-value 0.0169