Chemotherapy in the treatment of osteosarcoma

By | April 14, 2012

Chemotherapy in the treatment of osteosarcoma is commonly used in:
As an adjunct to surgery; some parts can not do radical surgery; as late palliative therapy; patient refused surgery. Effective progress in the chemical drugs, will lead to long-term reform of treatment in use, in particular, the time of amputation, level and radiation parts of dosage changes. The way chemotherapy, adjuvant chemotherapy, neoadjuvant chemotherapy and palliative chemotherapy.
Highly malignant osteosarcoma, amputation and other damaging their chances of survival after surgery has never been over 20% of osteosarcoma patients after amputation are more than 80% pulmonary metastasis of osteosarcoma after conventional chemotherapy for adjuvant therapy, called adjuvant chemotherapy, adjuvant chemotherapy significantly improved the prognosis of patients with osteosarcoma.
Neoadjuvant chemotherapy is chemotherapy before surgery began, and according to primary tumor responsiveness to chemotherapy adjuvant chemotherapy guided the amendment, the specific reasons and benefits are:
micrometastasis sensitive to chemotherapy, the first time to play a role in the killing of metastases;
kill the maximum extent possible primary tumor, so narrow, is conducive to the conduct of limb salvage surgery;
According to the Central Plains during chemotherapy, tumor response to chemotherapy timely adjustment of the individual;
selected high-risk patients may relapse or metastasis of tumor prior to receiving intensive therapy;
prognosis, effective preoperative chemotherapy, tumor cell necrosis rate of those patients continue to receive chemotherapy, and no chance of survival is relatively high.

Route of administration of preoperative chemotherapy: conventional intravenous administration. Preoperative intra-arterial administration of tumor nourish and strengthen the local effect of chemotherapy, limb salvage surgery for help, and systemic blood concentration and intravenous administration of the same, does not affect the effect of concomitant chemotherapy, CDP is a suitable choice for intra-arterial administration drugs. High-temperature isolation limb perfusion chemotherapy, the tumor can achieve higher local drug concentration, and temperature play with the maximum of the primary tumor killing effect, but systemic toxicity is less important.

Chemotherapy in the treatment of osteosarcoma, the current problems and prospects: rational, active chemotherapy, 80% of patients with osteosarcoma of the limb can be preserved, surgery alone cure rate also increased from less than 20% to 50% now – 80%. However, no matter what aggressive treatment, with a total of about 40% of patients in the treatment or course of treatment, lung metastasis occurred, resulting in treatment failure. In the current immunotherapy and biological therapy of various major breakthrough not before, how to further improve the cure rate with chemotherapy is a priority.

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