Top

Published in:

01-12-2006 | Review

Current strategies of chemotherapy in osteosarcoma

Authors: Dorothe Carrle, Stefan S. Bielack

Published in: International Orthopaedics | Issue 6/2006

Abstract

Osteosarcoma, the most common type of primary malignant tumour that develops in bone, can be classified into several different sub-types. While the majority of osteosarcomas are highly malignant, there are some low-grade variants. Since the introduction of chemotherapy into the multi-modal treatment regimen of high-grade osteosarcoma, its prognosis has impressively improved, with long-term survival being achieved in two-thirds of all patients. This review summarises current chemotherapeutic treatment strategies in classical osteosarcoma and also addresses the indication for chemotherapy in more unusual types and variants. It emphasises the need for treatment in specialised centres and within prospective, multi-institutional trials, amongst which EURAMOS1 and EURO-B.O.S.S are currently active in many European countries.

Ahmad SA, Patel SR, Ballo MT, Baker TP, Yasko AW, Wang X, Feig BW, Hunt KK, Lin PP, Weber KL, Chen LL, Zagars GK, Pollock RE, Benjamin RS, Pisters PW (2002) Extraosseous osteosarcoma: response to treatment and long-term outcome. J Clin Oncol 20:521–527PubMedCrossRef

Bacci G, Ferrari S, Longhi A, Picci P, Mercuri M, Alvegard TA, Saeter G, Donati D, Manfrini M, Lari S, Briccoli A, Forni C, Italian Sarcoma Group/Scandinavian Sarcoma Group (2002) High dose ifosfamide in combination with high dose methotrexate, adriamycin and cisplatin in the neoadjuvant treatment of extremity osteosarcoma: preliminary results of an Italian Sarcoma Group/Scandinavian Sarcoma Group pilot study. J Chemother 14:198–206PubMedCrossRef

Bielack SS, Kempf-Bielack B, Winkler K (1996) Osteosarcoma: relationship of response to preoperative chemotherapy and type of surgery to local recurrence. J Clin Oncol 14:683–684PubMed

Bielack SS, Kempf-Bielack B, Heise U, Schwenzer D, Winkler K (1999) Combined modality treatment for osteosarcoma occurring as a second malignant disease. Cooperative German-Austrian-Swiss Osteosarcoma Study Group. J Clin Oncol 17:1164–1174PubMed

Bielack SS, Kempf-Bielack B, Delling G, Exner GU, Flege S, Helmke K, Kotz R, Salzer-Kuntschik M, Werner M, Winkelmann W, Zoubek A, Jurgens H, Winkler K (2002) Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol 20:776–790PubMedCrossRef

Bielack SS, Machatschek JN, Flege S, Jurgens H (2004) Delaying surgery with chemotherapy for osteosarcoma of the extremities. Expert Opin Pharmacother 5:1243–1256PubMedCrossRef

Cade S (1955) Osteogenic sarcoma; a study based on 133 patients. J Roy Coll Surg Edin 1:79–111

Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 153:106–120PubMed

Ferrari S, Briccoli A, Mercuri M, Bertoni F, Picci P, Tienghi A, Del Prever AB, Fagioli F, Comandone A, Bacci G (2003) Postrelapse survival in osteosarcoma of the extremities: prognostic factors for long-term survival. J Clin Oncol 21:710–715PubMedCrossRef

10.

Fletcher CDM, Unni KK, Mertens F (eds) (2002) WHO classification of tumours pathology and genetics of tumours of soft tissue and bone. IARC Press, Lyon

11.

Fuchs N, Bielack SS, Epler D, Bieling P, Delling G, Korholz D, Graf N, Heise U, Jurgens H, Kotz R, Salzer-Kuntschik M, Weinel P, Werner M, Winkler K (1998) Long-term results of the co-operative German-Austrian-Swiss osteosarcoma study group’s protocol COSS-86 of intensive multidrug chemotherapy and surgery for osteosarcoma of the limbs. Ann Oncol 9:893–899PubMedCrossRef

12.

Goldstein-Jackson SY, Gosheger G, Delling G, Berdel WE, Exner GU, Jundt G, Machatschek JN, Zoubek A, Jurgens H, Bielack SS, Cooperative Osteosarcoma Study Group COSS (2005) Extraskeletal osteosarcoma has a favourable prognosis when treated like conventional osteosarcoma. J Cancer Res Clin Oncol 131:520–526PubMedCrossRef

13.

Goorin AM, Schwartzentruber DJ, Devidas M, Gebhardt MC, Ayala AG, Harris MB, Helman LJ, Grier HE, Link MP, Pediatric Oncology Group (2003). Presurgical chemotherapy compared with immediate surgery and adjuvant chemotherapy for nonmetastatic osteosarcoma: Pediatric Oncology Group Study POG-8651. J Clin Oncol 21:1574–1580PubMedCrossRef

14.

Grimer RJ, Bielack S, Flege S, Cannon SR, Foleras G, Andreeff I, Sokolov T, Taminiau A, Dominkus M, San-Julian M, Kollender Y, Gosheger G, European Musculo Skeletal Oncology Society (2005) Periosteal osteosarcoma – a European review of outcome. Eur J Cancer 41:2806–2811PubMedCrossRef

15.

Grimer RJ, Cannon SR, Taminiau AM, Bielack S, Kempf-Bielack B, Windhager R, Dominkus M, Saeter G, Bauer H, Meller I, Szendroi M, Folleras G, San-Julian M, van der Eijken J (2003) Osteosarcoma over the age of forty. Eur J Cancer 39:157–163PubMedCrossRef

16.

Hosalkar HS, Dormans JP (2004) Limb sparing surgery for pediatric musculoskeletal tumors. Pediatr Blood Cancer 42:295–310PubMedCrossRef

17.

Jaffe N, Carrasco H, Raymond K, Ayala A, Eftekhari F (2002) Can cure in patients with osteosarcoma be achieved exclusively with chemotherapy and abrogation of surgery? Cancer 95:2202–2210PubMedCrossRef

18.

Kempf-Bielack B, Bielack SS, Jurgens H, Branscheid D, Berdel WE, Exner GU, Gobel U, Helmke K, Jundt G, Kabisch H, Kevric M, Klingebiel T, Kotz R, Maas R, Schwarz R, Semik M, Treuner J, Zoubek A, Winkler K (2005) Osteosarcoma relapse after combined modality therapy: an analysis of unselected patients in the Cooperative Osteosarcoma Study Group (COSS). J Clin Oncol 23:559–568PubMedCrossRef

19.

Langer T, Stohr W, Paulides M, Kremers A, Dorr HG, Gobel U, Beck JD (2005) Prospective multicenter registration of major late sequelae in sarcoma patients using the Late Effects Surveillance System (LESS). Klin Pediatr 217:176–181CrossRef

20.

Link MP, Goorin AM, Miser AW, Green AA, Pratt CB, Belasco JB, Pritchard J, Malpas JS, Baker AR, Kirkpatrick JA et al (1986) The effect of adjuvant chemotherapy on relapse-free survival in patients with osteosarcoma of the extremity. N Engl J Med 314:1600–1606PubMedCrossRef

22.

Meyers PA, Heller G, Healey J, Huvos A, Lane J, Marcove R, Applewhite A, Vlamis V, Rosen G (1992) Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience. J Clin Oncol 10:5–15PubMed

21.

Meyers PA, Schwartz CL, Krailo M, Kleinerman ES, Betcher D, Bernstein ML, Conrad E, Ferguson W, Gebhardt M, Goorin AM, Harris MB, Healey J, Huvos A, Link M, Montebello J, Nadel H, Nieder M, Sato J, Siegal G, Weiner M, Wells R, Wold L, Womer R, Grier H (2005) Osteosarcoma: a randomized, prospective trial of the addition of ifosfamide and/or muramyl tripeptide to cisplatin, doxorubicin, and high-dose methotrexate. J Clin Oncol 23:2004–2011PubMedCrossRef

23.

Nakajima H, Sim FH, Bond JR, Unni KK (1997) Small cell osteosarcoma of bone. Review of 72 cases. Cancer 79:2095–2106PubMedCrossRef

24.

Okada K, Unni KK, Swee RG, Sim FH (1999) High grade surface osteosarcoma: a clinicopathologic study of 46 cases. Cancer 85:1044–1054PubMedCrossRef

25.

Picci P, Bacci G, Ferrari S, Mercuri M (1997) Neoadjuvant chemotherapy in malignant fibrous histiocytoma of bone and in osteosarcoma located in the extremities: analogies and differences between the two tumors. Ann Oncol 8:1107–1115PubMedCrossRef

26.

Picci P, Sangiorgi L, Rougraff BT, Neff JR, Casadei R, Campanacci M (1994) Relationship of chemotherapy-induced necrosis and surgical margins to local recurrence in osteosarcoma. J Clin Oncol 12:2699–2705PubMed

27.

Saeter G, Hoie J, Stenwig AE, Johansson AK, Hannisdal E, Solheim OP (1995) Systemic relapse of patients with osteogenic sarcoma. Prognostic factors for long term survival. Cancer 75:1084–1093PubMedCrossRef

28.

Smeele LE, Kostense PJ, van der Waal I, Snow GB (1997) Effect of chemotherapy on survival of craniofacial osteosarcoma: a systematic review of 201 patients. J Clin Oncol 15:363–367PubMed

29.

Smeland S, Wiebe T, Bohling T, Brosjo O, Jonsson K, Alvegard TA (2004) Chemotherapy in osteosarcoma. The Scandinavian Sarcoma Group experience. Acta Orthop Scand Suppl 75:92–98PubMed

30.

Tabone MD, Terrier P, Pacquement H, Brunat-Mentigny M, Schmitt C, Babin-Boilletot A, Mahmoud HH, Kalifa C (1999) Outcome of radiation-related osteosarcoma after treatment of childhood and adolescent cancer: a study of 23 cases. J Clin Oncol 17:2789–2795PubMed

31.

Waddell AE, Davis AM, Ahn H, Wunder JS, Blackstein ME, Bell RS (1999) Doxorubicin-cisplatin chemotherapy for high-grade nonosteogenic sarcoma of bone. Comparison of treatment and control groups. Can J Surg 42:190–199PubMed

Title: Current strategies of chemotherapy in osteosarcoma
Authors: Dorothe Carrle
Stefan S. Bielack
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 6/2006
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-006-0192-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Current strategies of chemotherapy in osteosarcoma

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2006

Giant cell tumour of bone: morphological, biological and histogenetical aspects

Use of purified beta-tricalcium phosphate for filling defects after curettage of benign bone tumours

Intramedullary knee arthrodesis as a salvage procedure after failed total knee replacement

Pathology of primary malignant bone and cartilage tumours

Lower limb salvage surgery: modular endoprosthesis in bone tumour treatment

Massive allografts in tumour surgery