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Osteosarcoma: a study of 130 cases
L Pochanugool1, D Sangthawan, T Subhadharaphandou
1Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Summary
Multidisciplinary osteosarcoma treatment combining chemotherapy, surgery, and irradiation achieved a 55% 5-year survival rate. Prophylactic lung irradiation significantly reduced metastasis, with low serum lactic acid dehydrogenase being a key prognostic factor.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy Oncology
Background:
- Osteosarcoma presents a significant challenge in pediatric and young adult oncology.
- Optimizing multidisciplinary treatment protocols is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of a specific multidisciplinary treatment protocol for osteosarcoma.
- To assess the impact of local and prophylactic lung irradiation on survival and metastasis.
Main Methods:
- Retrospective analysis of osteosarcoma patients treated with preoperative intraarterial and postoperative chemotherapy.
- Inclusion of surgery, with or without local irradiation, and prophylactic lung irradiation (PLI).
Main Results:
- Achieved a 5-year survival rate of 55%, which remained stable after 4.4 years.
- Local irradiation correlated with increased tumor destruction.
- PLI demonstrated a significant reduction in lung metastasis (16% vs. 48% without PLI) without complications.
- Low serum lactic acid dehydrogenase levels were identified as the most important prognostic factor.
Conclusions:
- The described multidisciplinary approach offers excellent survival rates for osteosarcoma.
- Prophylactic lung irradiation is a beneficial component in reducing lung metastasis.
- Further research is needed to determine the optimal treatment strategy for osteosarcoma.