Combined-modality treatment of osteogenic sarcoma of the skull.

The authors present the results of combined-modality treatment in eight patients with osteosarcoma of the skull. Six patients had de novo tumors, and two others had secondary sarcomas resulting from malignant transformation in Paget's disease. Wide surgical excision and combination chemotherapy were used in seven patients, and surgery and radiation therapy were employed in one case. Following chemotherapy, six patients underwent additional surgery. This aggressive approach resulted in four long-term survivors among the patients with de novo tumors. These data suggest that surgery in combination with chemotherapy provides the best potential for long-term disease control in patients with osteosarcoma of the skull.