Evaluation of chemotherapy before limb-sparing surgery for osteosarcoma.

Preoperative chemotherapy before limb-sparing surgery for osteosarcoma is used to reduce the size of the tumour, facilitate removal and prevent distant metastases. Fifteen patients with osteosarcoma were treated with six different protocols. Assessment of the clinical and radiological size of the lesion, of the histology of the resected specimen and of serum alkaline phosphatase levels were done. Greatest control of the tumour was obtained with the intravenous use of cisplatin, three times at intervals of three weeks before surgery, compared to the use of adriamycin or methotrexate in other protocols. Prompt surgery after preoperative chemotherapy and postoperative chemotherapy are advised.