Intra-arterial infusion of bromodeoxyuridine and radiotherapy in osteosarcoma and other bone malignancies

In order to avoid amputation, which does not seem to improve survival in osteosarcoma, we have initiated a limb-preservation program using intra-arterial radiosensitization. Eleven osteosarcomas with soft tissue involvement and six other bone malignancies were prospectively treated according to the following protocol: (a) surgical insertion of an intra-arterial catheter through a Dacron patch, (b) intra-arterial infusion of 15 mg/kg BUDR on days 1-2 every 5 days for 40 days, (c) 600 rads flash irradiation on day 3 every 5 days, X 8. Median follow-up time has been 36 months. In the osteosarcoma group, median survival has been 12 months. Four of the five osteosarcoma patients who died had received prophylactic HD methotrexate-vincristine-adriamycin systemic chemotherapy; one patient refused.