Impact of two cycles of preoperative chemotherapy with intraarterial cisplatin and intravenous doxorubicin on the choice of surgical procedure for high-grade bone sarcomas of the extremities
| Autor: | Jashvir Khurana, Dennis Priebat, Kathleen Patterson, Richard Schulof, Richard G. Buch, Martin M. Malawer, Barry Shmookler, Gregory H. Reaman, Barry Potter |
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| Rok vydání: | 1991 |
| Předmět: |
Leiomyosarcoma
Adult Male medicine.medical_specialty Adolescent medicine.medical_treatment Decision Making Bone Neoplasms Preoperative care Amputation Surgical Biopsy Antineoplastic Combined Chemotherapy Protocols Preoperative Care medicine Humans Orthopedics and Sports Medicine Prospective Studies Child Infusions Intravenous Survival rate Aged Chemotherapy medicine.diagnostic_test business.industry Sarcoma General Medicine Middle Aged medicine.disease Combined Modality Therapy Surgery Osteotomy Survival Rate Amputation Injections Intra-Arterial Doxorubicin Osteosarcoma Cisplatin business Follow-Up Studies |
| Zdroj: | Clinical orthopaedics and related research. (270) |
| ISSN: | 0009-921X |
| Popis: | The authors assessed the impact of two cycles of preoperative chemotherapy (POCT) with intraarterial cisplatin (120 mg/m2) and continuous intravenous doxorubicin hydrochloride (Adriamycin; 20 mg/m2/day x 3 days) on the decision to perform a limb-sparing procedure (LSP) or amputation in 22 patients with high-grade bone sarcomas of the extremities. The tumor types were osteosarcoma (17), malignant fibrous histiocytoma (three), leiomyosarcoma (one), and malignant schwannoma (one). Surgical stages were IIA (three), IIB (17), and IIIB (two). The prechemotherapy surgical options chosen were 12 amputations (55% of patients) and ten LSPs (45%). The initial decisions to amputate were based on a combination of the following: improper biopsy (five cases), large tumors (ten) and those with neurovascular encroachment (six), and pathological fracture (one). Following chemotherapy, 18 LSPs (81%) and four amputations (19%) were performed. Nine of 12 patients (75%) initially deemed unresectable were converted to LSP. The median tumor response (necrosis; range, 0%-100%) was 70%; ten of 22 specimens had necrosis greater than 95%. Median tumor necrosis for the patients treated by amputation and LSPs was 45% and 88%, respectively. Following surgery, all patients received four additional cycles of cisplatin and doxorubicin. The median follow-up period is 30 months; six patients have developed metastatic disease, with a median disease-free interval of 16.6 months. The rate of local tumor control is 95% (21 of 22 patients).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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