Skip to main content

Future Directions in the Management of Malignant Bone Tumors

  • Conference paper
Recent Advances in Musculoskeletal Oncology
  • 46 Accesses

Abstract

In spite of the considerable improvements produced by combination chemotherapy, there remain many problems still to be tackled in order to enhance the survival rate of patients with primary malignant bone tumors. There is some evidence that current chemotherapy programs have reached a plateau in their effect on survival, and that further improvements are going to be difficult both to obtain and to detect. This chapter describes some of the remaining problems and discusses some possibilities for advancement. The increasing specialization of the treatment of primary malignant bone tumors has had the advantage that, in many countries, the expertise has been concentrated in a few major centers. This means that national and international collaboration in clinical trials should become easier if agreement can be reached on the nature of the questions to be posed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Link MP, Goorin AM, Miser AW (1986) The effect of adjuvant chemotherapy on relapse-free survival in patients with osteosarcoma of the extremity. N Engl J Med 134: 1600–1606

    Article  Google Scholar 

  2. Eiber F, Giuliano A, Eckardt J, et al. (1987) Adjuvant chemotherapy for osteosarcoma: A randomized prospective trial. J Clin Oncol 5: 21–26

    Google Scholar 

  3. Stiller CA, Bunch KJ (1990) Trends in survival for childhood cancer in Britain diagnosed 1971–85. Br J Cancer 62: 806–815

    Article  PubMed  CAS  Google Scholar 

  4. Winkler K, Beron G, Kotz R (1984) Neoadjuvant chemotherapy for osteogenic sarcoma: Results of a cooperative German/Austrian study. J Clin Oncol 2: 617–624

    PubMed  CAS  Google Scholar 

  5. Winkler K, Beron G, Delling G (1988) Neoadjuvant chemotherapy of osteosarcoma: Results of a randomized cooperative trial (Coss-82) with salvage chemotherapy based on histological tumor response. J Clin Oncol 6: 329–337

    PubMed  CAS  Google Scholar 

  6. Ryan J, Baker L, Benjamin R (1990) Long-term follow-up in the cure of osteogenic sarcoma. Chir Organi Mov 75 (Supp 1): 48

    PubMed  CAS  Google Scholar 

  7. Ochs JJ, Freeman AI, Douglass HO (1978) Cis-dichlordiammineplatinum (II) in advanced osteogenic sarcoma. Cancer Treat Rep 62: 239–245

    PubMed  CAS  Google Scholar 

  8. Taylor WF, Ivins JC, Unni K (1989) Prognostic variables in osteosarcoma: A multiinstitutional study. J Natl Cancer Inst 81: 21–30

    Article  PubMed  CAS  Google Scholar 

  9. Bacci G, Picci P, Orlando M, et al. (1987) Prognostic value of serum alkaline phosphatase in osteosaracoma. Tumori 73: 331–336

    PubMed  CAS  Google Scholar 

  10. Rosen G, Huvos AG, Marcove R, Nirenberg A (1986) Telangiectatic osteogenic sarcoma. Clin Orthop 207: 164–173

    PubMed  Google Scholar 

  11. Sim FH, Unni KK, Beabout JW, Dahlin DC (1979) Osteosarcoma with small cells simulating Ewing’s tumor. J Bone Joint Surg [AM] 61A: 207–215.

    CAS  Google Scholar 

  12. Rosen G, Caparros B, Huvos AG (1982) Preoperative chemotherapy for osteogenic sarcoma: Selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy. Cancer 49: 1221–1230

    Article  PubMed  CAS  Google Scholar 

  13. Eckardt JJ, Eiber FR, Grant TT, et al. (1985) Management of stage IIB osteogenic sarcoma: Experience at the Unviersity of California, Los Angeles Cancer Treatment Symposia 3: 117–130

    Google Scholar 

  14. Jaffe N, Robertson R, Ayala A (1985) Comparison of intra-arterial cis-diamminedichloroplatinum II with high dose methotrexate and citrovorum factor rescue in the treatment of primary osteosarcoma. J Clin Oncol 3: 1101–1110

    PubMed  CAS  Google Scholar 

  15. Benjamin RS (1989) Regional chemotherapy for osteosarcoma. Semin Oncol 16: 323–327

    PubMed  CAS  Google Scholar 

  16. Goorin AM, Delorey MJ, Lack EE, et al. (1984) Prognostic significance of complete surgical resection of pulmonary metastases in patients with osteogenic sarcoma: Analysis of 32 patients. J Clin Oncol 2: 425–431

    PubMed  CAS  Google Scholar 

  17. Burgers JHV, Brair K, van Dobbenburgh AO, et al. (1980) Role of metastatectomy without chemotherapy in the management of osteosarcoma in children. Cancer 45: 1664–1668

    Article  PubMed  Google Scholar 

  18. Han M-T, Telander RL, Pairolero PC, et al. (1981) Aggressive thoracotomy for pulmonary metastatic osteogenic sarcoma in children and young adolescents. J Ped Surg 16: 928–933

    Article  CAS  Google Scholar 

  19. Meyer WH, Schell MJ, Kumar APM (1987) Thoracotomy for pulmonary metastatic osteosarcoma. An analysis of prognostic indicators of survival. Cancer 59: 374–379

    Article  PubMed  CAS  Google Scholar 

  20. Sutow WW, Sullivan MP (1962) Cyclophosphamide therapy in children with Ewing’s sarcoma. Cancer Chemother Rep 23: 55–60

    PubMed  CAS  Google Scholar 

  21. Selawry OS, Holland JF, Wolman IJ (1968) Effect of vincristine on malignant solid tumors in children. Cancer Chemother Rep 53: 497–500

    Google Scholar 

  22. Wang JJ, Cortes E, Sinks L, Holland JF (1971) Therapeutic effect and toxicity of adriamycin in patients with neoplastic disease. Cancer 28: 837–843

    Article  PubMed  CAS  Google Scholar 

  23. Senyszyn JJ, Johnson RE, Curran RE (1970) Treatment of metastatic Ewing’s sarcoma with Actinomycin D (NSC-3053). Cancer Chemother Rep 54: 103–107

    PubMed  CAS  Google Scholar 

  24. Oldham RK, Pomeroy TC (1972) Treatment of Ewing’s sarcoma with adriamycin (NSC-123127). Cancer Chemother Rep 56: 635–639

    PubMed  CAS  Google Scholar 

  25. Magrath I, Sandlund J, Raynor A (1986) A phase II study of ifosfamide in the treatment of recurrent sarcomas in young people. Cancer Chemother Pharmacol 18 (Suppl 2): 25–28

    Article  Google Scholar 

  26. Hayes FA, Green A, Thompson E (1983) Phase II trial of VP 16–213 in pediatric solid tumors (Abstract No C-256). Proc Am Soc Cl in Oncol

    Google Scholar 

  27. Nesbit ME, Perez CA, Tefft M (1981) Multimodal therapy for the management of primary non metastatic Ewing’s sarcoma of bone: An Intergroup Study. Nat Cancer Inst Monogr 56: 255–262

    PubMed  Google Scholar 

  28. Nesbit ME, Gehan EA, Burgert EO (1990) Multimodal therapy for the management of primary, non-metastatic Ewing’s sarcoma of bone: A long-term follow-up of the first Intergroup study. J Clin Oncol 8: 1664–1674

    PubMed  Google Scholar 

  29. Hayes FA, Thompson E, Meyer W, et al. (1989) Therapy for localized Ewing’s sarcoma of bone. J Clin Oncol 7: 208–213

    PubMed  CAS  Google Scholar 

  30. Jürgens H, Exner U, Gadner H (1988) Multidisciplinary treatment of primary Ewing’s sarcoma of bone. A 6-year experience of a European cooperative trial. Cancer 61: 23–32

    Article  PubMed  Google Scholar 

  31. Bacci G, Picci P, Gherlinzoni F, et al. (1985) Localized Ewing’s sarcoma of bone: Ten years’ experience at the Instituto Orthopedico Rizzoli in 124 cases treated with multimodal therapy. Eur J Cancer Clin Oncol 21: 163–173

    Article  PubMed  CAS  Google Scholar 

  32. Rosen G, Caparros B, Nirenberg A (1981) Ewing’s sarcoma: Ten-year experience with adjuvant chemotherapy. Cancer 47: 2204–2213

    Article  PubMed  CAS  Google Scholar 

  33. Rosen G (1982) Current management of Ewing’s sarcoma. Progr Clin Cancer 8: 267–282

    CAS  Google Scholar 

  34. Kissane JM, Askin FB, Foulkes M, Strattan LB, Shirley SF (1983) Ewing’s sarcoma of bone: Clinico-pathological aspects of 303 cases from the Intergroup Ewing’s Sarcoma Study. Hum Path 14: 773–779

    Article  PubMed  CAS  Google Scholar 

  35. Jaffe R, Santamaria M, Unis EJ (1984) The neuroectodermal tumor of bone. Am J Surg Pathol 8: 885–898

    Article  PubMed  CAS  Google Scholar 

  36. Daugaard S, Kamby C, Sunde LM, et al. (1989) Ewing’s sarcoma: A retrospective study of histological and immunohistochemical factors and their relation to prognosis. Virchows Arch [A] 414: 243–251

    Article  CAS  Google Scholar 

  37. Hartman KR, Triche TJ, Kinsella TJ, Miser JS (1991) Prognostic value of histopathology in Ewing’s sarcoma. Long-term follow-up of distal extremity tumors. Cancer 67: 163–171

    Article  PubMed  CAS  Google Scholar 

  38. Suit HD (1975) Role of therapeutic radiology in cancer of bone. Cancer 35: 930–935

    Article  PubMed  CAS  Google Scholar 

  39. Newton WA, Meadows AT, Shimada H (1991) Bone sarcomas as second malignant neoplasms following childhood cancer. Cancer 67: 193–201

    Article  PubMed  Google Scholar 

  40. Cangir A, Vietti TJ, Gehan EA, et al. (1990) Ewing’s sarcoma metastatic at diagnosis. Results and comparisons of two Intergroup Ewing’s sarcoma studies. Cancer 66: 887–893

    Article  PubMed  CAS  Google Scholar 

  41. Earl HM (1987) Chemotherapy of rare malignant bone tumours. In: Souhami RL (ed) Bone Tumours. Ballières Clinical Oncology, vol 1. Ballières Tindall, London, pp 223–241

    Google Scholar 

  42. den Heeten GJ, Schraffordt-Koops H, Kamps WA, et al. (1985) Treatment of malignant fibrous histiocytoma of bone. A plea for primary chemotherapy. Cancer 56: 37–40

    Article  Google Scholar 

  43. Urban C, Rose C, Huvos AG (1983) Chemotherapy of malignant fibrous histiocytoma of bone. A report of five cases. Cancer 51: 795–802

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Japan

About this paper

Cite this paper

Souhami, R.L. (1992). Future Directions in the Management of Malignant Bone Tumors. In: Uchida, A., Ono, K. (eds) Recent Advances in Musculoskeletal Oncology. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68364-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-68364-3_12

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68366-7

  • Online ISBN: 978-4-431-68364-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics