[Historical improvement in the treatment of osteosarcoma]

In the past decade, advances in chemotherapeutic agents and in diagnostic devices have led to improvement in the results of treatment for osteosarcoma. To evaluate the factor which brought about such improvement, historical therapeutic regimens were analysed. Eighty-three osteosarcoma cases were treated in our institute from 1955 to 1988 and categorized into six groups with the following therapeutic regimens: N-0: No treatment (including biopsy) N-1: Surgery alone N-2: Post surgery adjuvant therapy N-3: Intra-arterial continuous infusion N-4: Distal arterial blockade infusion N-5: Balloon-occluded arterial infusion. (N-3, 4 and 5 imply neo-adjuvant chemotherapy). Overall five-year survival rate was 48.8% (included Enneking's stage III). The survival rate improved from N-1 to N-5 in stepwise fashion, and N-5 reached 80% at two-year survival. We concluded that neo-adjuvant chemotherapy was not only effective to control the local lesion but also to prevent lung metastasis.