Radiotherapy for local control of osteosarcoma

DeLaney, Thomas F.; Park, Lily; Goldberg, Saveli; Hug, Eugen B.; Liebsch, Norbert J.; Munzenrider, John E.; Suit, Herman D.

doi:10.1016/j.ijrobp.2004.05.051

Cited by 265 publications

(180 citation statements)

References 19 publications

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“…13,14 For osteosarcoma, adjuvant radiation has not been shown to improve overall survival after surgery and chemotherapy and therefore is not routinely offered to patients. 28 In addition, prophylactic radiation of the lung fields to prevent pulmonary metastases has been studied in the past, but results from randomized studies have been too inconsistent to support its widespread practice. 29 Future studies of LB100 in osteosarcoma and other tumors with propensity to spread to the lungs may investigate whether LB100 exposure prior to prophylactic lung field radiation may reduce the incidence of pulmonary metastases in tumor models, in vivo.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of protein phosphatase 2A with the small molecule LB100 overcomes cell cycle arrest in osteosarcoma after cisplatin treatment

Zhang¹,

Hong

et al. 2015

Cell Cycle

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Section: Discussionmentioning

confidence: 99%

Inhibition of protein phosphatase 2A with the small molecule LB100 overcomes cell cycle arrest in osteosarcoma after cisplatin treatment

Zhang¹,

Hong

et al. 2015

Cell Cycle

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“…This has resulted in improved survival, but these studies have been primarily limited to patients with limb and not spine involvement. Delaney et al [10] found a significant 5-year survival advantage between patients who underwent surgical resection (75 %) relative to those who underwent biopsy (25 %) for patients with osteosarcoma. Of the 41 patients in this series, patients with metastatic disease were included and only eight patients had spine involvement [10].…”

Section: Discussionmentioning

confidence: 99%

Association of surgical resection and survival in patients with malignant primary osseous spinal neoplasms from the Surveillance, Epidemiology, and End Results (SEER) database

et al. 2012

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Objective Malignant osseous spinal neoplasms are aggressive tumors associated with poor outcomes despite aggressive multidisciplinary measures. While surgical resection has been shown to improve short-term local disease control, it remains debated whether surgical resection is associated with improved overall survival in patients with malignant primary osseous spinal neoplasms. The aim of this manuscript is to review survival data from a US cancer registry spanning 30 years to determine if surgical resection was independently associated with overall survival. Methods The SEER registry was queried to identify cases of histologically confirmed primary spinal chordoma, chondrosarcoma, osteosarcoma, or Ewing's sarcoma of the mobile spine and pelvis. Patients with systemic metastasis were excluded. Age, gender, race, tumor location, and primary treatments were identified. Extent of local tumor invasion was classified as confined within periosteum versus extension beyond periosteum to surrounding tissues. The association of surgical resection with overall survival was assessed via Cox analysis adjusting for age, radiotherapy, and tumor invasiveness.Results 827 patients were identified with non-metastatic primary osseous spinal neoplasms (215 chordoma, 282 chondrosarcoma, 158 osteosarcoma, 172 Ewing's sarcoma). Overall, median survival was histology specific (chordoma, 96 months; Ewing's sarcoma, 90 months; chondrosarcoma, 88 months; osteosarcoma, 18 months). Adjusting for age, radiation therapy, and extent of local tumor invasion in patients with isolated (non-metastatic) spine tumors, surgical resection was independently asso- Conclusion In our analysis of a 30-year US populationbased cancer registry (SEER), patients undergoing surgical resection of primary spinal chordoma, chondrosarcoma, Ewing's sarcoma, or osteosarcoma demonstrated prolonged overall survival independent of patient age, extent of local invasion, or location. Surgical resection may play a role in prolonging survival in the multi-modality treatment of patients with these malignant primary osseous spinal neoplasms.

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“…The majority of patients had received proton radiotherapy. 18 It is plausible that with doses of 70 Gy or higher unresectable osteosarcoma and nonrhabdomyosarcoma soft-tissue sarcomas could be controlled with radiation. Protons are the most feasible means to achieve dose escalation to these levels.…”

Section: Pediatric Sarcomasmentioning

confidence: 99%

Current status of radiotherapy with proton and light ion beams

Greco

Wolden

2007

Cancer

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Several model studies have shown potential clinical advantages with charged particles (protons and light ions) compared with 3D-conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in many disease sites. The newly developed intensity-modulated proton therapy (IMPT) often yields superior dose distributions to photon IMRT, with the added advantage of a significant reduction in the volume of healthy normal tissues exposed to low-to-medium doses. Initially, the major emphasis in clinical research for proton and light ion therapy was dose escalation for inherently radioresistant tumors, or for lesions adjacent to critical normal structures that constrained the dose that could be safely delivered with conventional x-ray therapy. Since the advent of IMRT the interest in particle therapy has gradually shifted toward protocols aimed at morbidity reduction. Lately the emphasis has mostly been placed on the potential for reduced risk of radiation-induced carcinogenesis with protons. Compared with 3D-CRT, a 2-fold increase has been theoretically estimated with the use of IMRT due to the larger integral volumes. In the pediatric setting, due to a higher inherent susceptibility of tissues, the risk could be significant, and the benefits of protons have been strongly emphasized in the literature. There is a significant expansion of particle therapy facilities around the world. Increasing public awareness of the potential benefits of particle therapy and wider accessibility for patients require that treating physicians stay abreast of the clinical indications of this radiotherapy modality. The article reviews the available literature for various disease sites in which particle therapy has traditionally been considered to offer clinical advantages and to highlight current lines of clinical research. The issue of radiation-induced second malignancies is examined in the light of the controversial epidemiological evidence available. The cost-effectiveness of particle therapy is also discussed. Cancer 2007;109: 1227-38. 2007 American Cancer Society.KEYWORDS: radiotherapy, proton therapy, light ions, intensity modulated radiotherapy, second cancers. C harged particles (protons and light ions) have a finite range in tissues. The interaction probability to cause ionization increases as they lose velocity traversing through tissues, so that a peak of dose occurs at a depth proportional to the energy of each particle. Beyond this peak no further dose deposition occurs. This phenomenon was described by William Bragg over 100 years ago.1 The dose peak may be 'spread out' to achieve a plateau of uniform dose to precisely cover the target while sparing adjacent normal structures. Passively scattered beams of a certain aperture can be produced by means of range-shifting modulators of variable thickness providing spread-out Bragg peaks (SOBP) for clinical use. The recent introduction of the spot scanning method represents a major advance in particle therapy.2 In this method, small pencil beams of a certain

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Radiotherapy for local control of osteosarcoma

Cited by 265 publications

References 19 publications

Inhibition of protein phosphatase 2A with the small molecule LB100 overcomes cell cycle arrest in osteosarcoma after cisplatin treatment

Inhibition of protein phosphatase 2A with the small molecule LB100 overcomes cell cycle arrest in osteosarcoma after cisplatin treatment

Association of surgical resection and survival in patients with malignant primary osseous spinal neoplasms from the Surveillance, Epidemiology, and End Results (SEER) database

Current status of radiotherapy with proton and light ion beams

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