Neoadjuvant Chemotherapy and Local Radiotherapy for High-Grade Osteosarcoma of the Extremities

Dose-finding study of 153Sm-EDTMP in patients with poor prognosis osteosarcoma

“…Recent studies, however, have indicated that lower dose radiotherapy can assist in providing local control of osteosarcoma for patients with marginal resections. 5 This finding supports the development of chemoradiotherapy treatment protocols for patients with high-risk disease, especially if treatment can be targeted directly to the tumor rather than to surrounding normal tissue.…”

The Multidisciplinary Management of Osteosarcoma

“…Whereas radical resection by amputation was the mainstay of therapy into the 1970s, currently more than 85% of patients undergo wide resection with limb-sparing surgery [36]. Although no randomized studies have been done, large retrospective studies have • Radiation therapy in the primary local control setting should be reserved on a case-by-case basis for patients with unresectable tumors and/or where margins of resection are positive [50,51]. Typically these tumors involve the head and neck or spinal region.…”

Mechanisms of therapy resistance in osteosarcoma: a review

“…Therefore the prognosis for these patients is worse compared to patients with OS of the extremity and 5-year survival is approximately 25% [3,4,6,7]. Attempts to improve therapy efficacy by dose escalation, alterations in combinations of chemotherapy and irradiation therapy (particularly for patients with inoperable OS), either combined with chemotherapy or not, have not improved survival outcomes [5,[8][9][10][11][12][13][14][15]. Resistance to therapy, both intrinsic and acquired, can be accountable for essential treatment failure as well as for recurrence after a disease-free interval.…”