Current Concept and New Strategy in Osteosarcoma Management

Jae Do Kim

doi:10.5124/jkma.2006.49.12.1119

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Kim: Current Concept and New Strategy in Osteosarcoma Management

Special Issue

Diagnosis and Current Treatment of Bone Tumor

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2006; 49(12): 1119-1125.

Published online: 31 December 2006

DOI: https://doi.org/10.5124/jkma.2006.49.12.1119

Current Concept and New Strategy in Osteosarcoma Management

Jae Do Kim, MD

Department of Orthopaedic Surgery, Kosin University College of Medicine, Korea. jdkim@ns.kosinmed.or.kr

Abstract

Major progress in the management of osteosarcoma has been made due to advances in diagnostic imaging, operative technique, and chemotherapy, resulting in an improved survival. However, 20~30% of patients with osteosarcoma still develop distant metastases despite combined modality treatment. Currently various experimental efforts are being proposed to the future new strategy include drug resistance, suppression of metastasis mechanism, and targeted therapy to convert the incurable rate of 20~30% upto complete cure rate.

Keywords: Osteosarcoma, Current therapy, Survival, New strategy

Figures and Tables

Figure 1

Treatment results in classical osteosarcoma. Schematic illustration of the treatment evolution in patients with classical osteosarcoma. Bruland O.S. European J. Cancer. 1997; 33(11): 1725 - 31

Figure 2

The graph shows the overall and CDF (Continuous disease free) survival of patients of osteosarcoma (stage II B)

Figure 3

(A) Simple radiography of nine year old femail patinet with osteosarcoma in the distal femur, shows osteolytic lesion on the metaphysis with cortical disruption, Codman's triangle and sunburst sign

(B) There is high signal intensity tumor involving distal femoral with soft tissue extension

(D) Post-opertively at 2 years and 5 months, mono-fixator and plate were applied for leg lengthening due to 6cm of leg length discrepancy

(E) Post-opertively at 2 years and 6 months, the X-ray shows epiphyseal collapse.

(F) Post-opertively at 3 years and 11 months, the growing prosthesis was applied. During follow-up, infection occurred.

(G) Post-opertively at 11 years and 8 months, a silver-coated prosthesis was inserted after infection was controlled.

Table 1

Most recent multicentric osteosarcoma protocols (1986~2000)

Doxo = Doxorubicin, DCP = Cisplatin, MTX=Methotrexate, Bleo = Bleomycine, CTY = Cyclophosphamide, Act = Actynomicin, VCR = Vincristine, VP16 = Etoposide, IFO = Ifosfamide, MTP = Muramyl Trypeptide Phosphatidyl ethanolamine

References

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