[Preoperative systemic chemotherapy of patients with osteosarcoma: a preliminary study of nine cases]

Nine patients with osteosarcoma were treated with cisplatinum and high-dose methotrexate therapy. According to the clinical responses to each drug, we selected and used the effective one with adriamycin or bleomycin, cyclophosphamide and actinomycin-D combination therapy. We treated patients with these protocols for several months (two and one-half to eight months). Both high-dose methotrexate and cisplatinum were effective in two cases, methotrexate or cisplatinum was effective in two patients individually (both resistant), but ifosfamide was effective in one case. No differences between any drug in the pattern of effective drug response. It is possible to exclude non-effective drugs from the preoperative schedule according to the degree of clinical responses manifested within one or two weeks. This preliminary study suggested that intensive systemic preoperative chemotherapy will control primary and micrometastatic lesions of osteosarcoma and improve the treatment for primary and advanced osteosarcoma.