OSTEOGENIC SARCOMA (OSTEOSARCOMA): RESULTS OF THERAPY

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Abstract
Between November 1, 1955 and June 30, 1973, 46 patients with osteosarcoma without evidence of metastases were admitted to the UCLA Center for Health Sciences. The follow-up was 100 per cent. The plan for therapy after biopsy has been to give preoperative megavoltage radiation therapy, 6,000 to 7,000 rads tumor dose at the rate of 900 rads per week to the whole limb or bone involved and then to consider surgical ablation 4 to 6 months later, if metastases have not occurred. The average duration of symptoms was 2.5 months, and the average time period for the appearance of metastases calculated from the onset of therapy was 5.5 months. Eighty-seven per cent had metastases within a period of 14 months after diagnosis with the majority appearing usually in the lungs in 9 months or less. There have been 11 long-term survivors. There were no 5 year survivors from surgery only. There were 3 long-term survivors from radiation therapy only; 6 who were treated by radiation therapy and surgery; 1 treated by surgery, radiation therapy, and chemotherapy; and 1 who had radiation therapy and chemotherapy. It is believed that maximum results which can be obtained from surgery alone or from preoperative radiation therapy plus ablative surgery have been achieved, and the results are approximately 20 per cent 5 year survivals. Since osteosarcoma is a systemic disease and because of the brief period of symptoms and rapid onset of metastases following therapy, any further improvement in survival statistics will have to be the result of additional therapy directed to the prevention of systemic spread of the disease. There are some cases of osteosarcoma which represent localized disease, possibly 5 to 15 per cent, but there is no method to determine which ones they are at the present time prior to the initiation of therapy.

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