[Adjuvant chemotherapy for osteosarcoma in Japan--past, present and future]

The therapeutic results for osteosarcoma were very discouraging before 1970 in Japan despite many modes of treatment. In 1960, Miki introduced the regional perfusion technique into the treatment of osteosarcoma, and in 1963, Akaboshi pioneered the intraarterial infusion technique. By these methods, a five-year survival rate about 30% was achieved during the period from 1971 to 1976. In Japan, the five-year disease-free survival rate will soon exceed 50% thanks to intensive multi-drug adjuvant chemotherapy, considering the therapeutic results of 117 cases of JOOG treated during 6 years from 1975 to 1980 and 114 cases included in the Group Study of Osteosarcoma treated during 8 years from 1973 to 1981. In most cases, ablative surgery must still be considered the standard method of treatment. However, the importance of preoperative adjuvant chemotherapy is emphasized because limb-saving operations have become an increasingly common feature in the management of osteosarcoma as a result of the recent advances achieved by intensive multi-drug adjuvant chemotherapy.