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Radiotherapy for local control of osteosarcoma
Thomas F DeLaney1, Lily Park, Saveli I Goldberg
1Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. tdelaney@partners.org
International Journal of Radiation Oncology, Biology, Physics
|January 26, 2005
Summary
Radiotherapy (RT) offers effective local control for osteosarcoma when complete surgical resection is not feasible. This treatment is particularly beneficial for managing microscopic residual disease after surgery, improving patient outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Achieving satisfactory margins during osteosarcoma resection can be challenging.
- Local control of osteosarcoma is difficult in cases of incomplete resection.
Purpose of the Study:
- To evaluate the efficacy of radiotherapy (RT) for osteosarcoma in patients with unresectable or inadequately resected tumors.
- To assess the impact of RT on local control, progression-free survival, metastasis-free survival, and overall survival.
Main Methods:
- Retrospective review of 41 osteosarcoma patients treated with external beam photons and/or protons between 1980 and 2002.
- Analysis included patients with unresected, close, or positive margins.
- Outcomes assessed included local control, progression-free survival, metastasis-free survival, and overall survival.
Main Results:
- The 5-year overall local control rate was 68%.
- Local control and survival rates were significantly higher for patients with gross total or subtotal resection compared to biopsy only (p < 0.001).
- Patients treated at primary presentation had better overall survival than those treated for recurrence (p < 0.05).
Conclusions:
- Radiotherapy is effective in achieving local control for osteosarcoma when complete surgical resection with negative margins is not possible.
- RT appears most effective when treating microscopic or minimal residual disease.
- Extent of surgical resection significantly impacts local control and survival outcomes.