Palliative Radiation in Metastatic Osteosarcoma
The patient is an 18-year-old black woman presenting with osteosarcoma arising in the distal femur and metastasizing to the lungs. Multidrug chemotherapy with methotrexate, ifosfamide, and cisplatin for 5 months resulted in an initially good response, although doxorubicin (Adriamycin) had to be discontinued because of cardiac arrhythmia. A wide resection with knee joint replacement was accomplished but there was rather rapid recurrence, both locally in the femur and the lung. The patient had an above-the-knee amputation for the local recurrence and was started on ifosfamide for the pulmonary metastases. During the next 6 months the patient developed left leg paresis and urinary retention associated with an intramedullary metastasis at T11–12. Further data is not provided regarding the response of the pulmonary metastases to ifosfamide, but on physical examination the patient was noted to be cachectic and on nasal oxygen.
KeywordsToxicity Fractionation Oncol Sarcoma Doxorubicin
Unable to display preview. Download preview PDF.
- Benjamin RS, Chawla SP, Carrasco CH, Raymond AK, Murray JA, Armen T, Patel S, Wallace S, Ayala A, Papadopoulos NE et al. (1992) Preoperative chemotherapy for osteosarcoma with intravenous adriamycin and intraarterial cisplatinum. Ann Oncol 3(S2): 3–6Google Scholar
- Bertoli R, Brady LW, Thomas P (1987) Tumors of the bone. In: Perez CA, Brady LW (eds) Principles and practice of radiation oncology. Lippincott, Philadelphia, pp 1169–1172Google Scholar
- Nowakowski V, Castro JR, Petti PL, Collier JM, Daftari I, Ahn D, Gauger G, Gutin P, Linstadt D, Phillips TL (1991) Charged particle radiotherapy of paraspinal tumors. Int J Radiat Oncol Biol Phys 22:295–303Google Scholar
- Saeter G, Alvegard TA, Elomaa I, Stenwig AE, Holmstrom T, Solheim OP (1991) Treatment of osteosarcoma of the extremities with the T10 protocol, with emphasis on the effects of preoperative chemotherapy with single-agent high-dose methotrexate: a Scandinavian sarcoma group study. J Clin Oncol 9(10): 1766–1775PubMedGoogle Scholar
- Solheim OP, Saeter G, Elomaa I, Alvegard TA (1992) The treatment of osteosarcoma: present trends. The Scandinavian sarcoma group experience. Ann Oncol 3(2): 7–11Google Scholar
- Weichselbaum RR, Cassady JR, Jaffe N (1983) Radiation therapy in osteosarcoma. In: Jaffe N (ed) Solid tumors in childhood. CRC, Boca Raton pp 183–190Google Scholar