Bacci G, Pignatti G, Dallari D, Mercuri M, Bertoni F, Bacchini P, Fontana M, Avella M, Campanacci M
Department of Internal Medicine and Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy.
J Chemother. 1989 Jun;1(3):190-6. doi: 10.1080/1120009x.1989.11738889.
Twelve patients with telangiectatic osteogenic sarcoma (TOS) of the extremities were treated with neoadjuvant chemotherapy, according to two different protocols. Preoperatively the patients received high-dose methotrexate(HD-MTX)/cisplatinum(CPD) or HD-MTX/CPD/adriamycin(ADM). CPD was delivered intra-arterially, the other drugs intravenously. Limb salvage surgery was performed in eight instances and four patients underwent amputation. Post operative chemotherapy was tailored according to the grade of necrosis determined by preoperative treatment on the primary tumor. In ten cases (83%) the grade of necrosis resulted higher than 95%. The mean length of follow-up was 3.5 years with a range of 18 to 72 months. Ten patients (83%) remained continuously disease-free, while two patients developed lung metastases and died of uncontrolled disease. No local recurrences were observed. These results are better than those observed in 167 contemporary cases of conventional osteosarcoma treated with the same protocols. This study confirms that TOS is not always a lethal tumor as suggested by prior reports. Employing neoadjuvant chemotherapy a high percentage of patients with TOS can be cured and in most of them, limb sparing surgery is possible and safe.
12例肢体毛细血管扩张性骨肉瘤（TOS）患者按照两种不同方案接受了新辅助化疗。术前患者接受大剂量甲氨蝶呤（HD-MTX）/顺铂（CPD）或HD-MTX/CPD/阿霉素（ADM）治疗。CPD通过动脉内给药，其他药物通过静脉给药。8例患者接受了保肢手术，4例患者接受了截肢手术。术后化疗根据术前对原发肿瘤治疗所确定的坏死程度进行调整。10例（83%）患者的坏死程度高于95%。平均随访时间为3.5年，范围为18至72个月。10例（83%）患者持续无病生存，2例患者发生肺转移并死于疾病无法控制。未观察到局部复发。这些结果优于同期采用相同方案治疗的167例传统骨肉瘤病例。本研究证实，TOS并不总是如先前报道所提示的那样是一种致命肿瘤。采用新辅助化疗，大部分TOS患者可以治愈，并且其中大多数患者可行保肢手术且安全。
