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PubMed2000

[Evidence-based chemotherapy for patients with bone and soft part sarcoma].

In the present paper, we review the evidence for chemotherapy in patients with bone and soft part sarcoma and discuss the contributions and improvements made by chemotherapy to the treatment of patients with bone and soft part sarcoma. In the osteosarcoma and Ewing's sarcoma family, neoadjuvant and adjuvant chemotherapy have improved the 5-year disease-free survival to 60%, and limb-salvage operations have improved this to 70-80% in cases of non-metastatic malignant bone tumor. Several trials were conducted in order to overcome rate relapses and metastatic bone sarcoma. With osteosarcoma, thoracotomy improved the survival of lung metastatic patients, but CDDP-ADM branch switched according to the neoadjuvant chemotherapy and failed to elevate the continuous disease-free survival of patients. Dose intensive use of cytotoxic drugs with G-CSF or autologous bone marrow transplantation and multidrug programs were conducted in preliminary studies and achieved favorable results in a high risk factors group for tumors of the Ewing's sarcoma family. Surgical techniques have brought improvements in the treatment of soft tissue sarcoma, but there has been no impact by chemotherapy. Ifosfamide and adriamycin combination is being evaluated in the treatment of local advanced and metastatic soft part sarcoma by local control rate or survival from relapse.

Bone Neoplasms↗
PubMed1999

MRI of primary lymphoma of bone: cortical disorder as a criterion for differential diagnosis.

To investigate the pattern and dimension of cortical bone abnormality on magnetic resonance imaging (MRI) as a feature to distinguish primary lymphoma of bone from osteosarcoma and Ewing sarcoma, 46 patients with primary malignant bone lesions with a soft tissue mass (16 osteosarcomas, 15 Ewing sarcomas, 15 lymphomas) were examined with MRI (T1-weighted pre-/postcontrast spin-echo sequences and T2-weighted spin-echo and fast spin-echo sequences; 1.5 T system). Qualitative image analysis revealed no differences for signal characteristics and enhancement. Lymphomas appeared significantly more often homogeneous (47%; Ewing sarcoma 20%; osteosarcoma 6%/o), and patients were significantly older (cutoff point 30 years). Lymphomas showed significantly less frequent cortical abnormality (60%; Ewing sarcoma 87%; osteosarcoma 100%), complete penetration (13%; Ewing sarcoma 67%; osteosarcoma 87%), focal destruction (13%; Ewing sarcoma 40%; osteosarcoma 81%), and complete destruction (0%; Ewing sarcoma 13%; osteosarcoma 19%). In conclusion, primary lymphoma of bone is characterized by minimal cortical changes despite an accompanying soft tissue mass in a patient over 30 years of age.

Adolescent↗
PubMed1999

Diagnosis and tumor response in osteosarcoma and Ewing's sarcoma, according to treatment protocols SSG II, SSG VIII, ISG/SSG I, SSG IV and SSG IX.

114 patients with osteosarcoma in the extremities had been reported to the SSG II trial, 132 to the SSG VIII trial and, until October 1998, 99 to the ISG/SSG I trial. The SSG IV trial included 53 patients and the SSG IX trial 104 patients until October 1998. In the SSG II trial, 19% were good responders (grades III and IV) as compared to 51% in the SSG VIII trial. On reevaluation was the response changed in one forth of the cases in both the SSG II and SSG VIII trials. In 9 and 10 cases (8%), respectively, the reevaluation resulted in a change from "good responder" to "bad responder". In the ISG/SSG I trial, the preliminary results showed a good response in 22% of the cases. In the SSG IV trial, 44% were good responders (grades III and IV), as compared to 54% in the SSG IX trial.

Antineoplastic Agents↗
PubMed2004

Synovial sarcoma after chemotherapy for osteosarcoma: a case report.

A 23-year-old man had eight cycles of adjuvant chemotherapy including doxorubicin, cisplatin, methotrexate, and ifosfamide and radical surgery for biopsy-proved osteosarcoma of the right fibular shaft. Two years after the initial diagnosis, he noticed a mass in the medial aspect of his right knee. Magnetic resonance imaging scans revealed a soft tissue tumor measuring 2 x 2 cm in the pericapsular region of the right knee. Histologically, this soft tissue tumor was composed of spindle cells with occasional atypical mitoses and without matrix formation. Immunohistochemically, the tumor cells were positive for vimentin, cytokeratin, and epithelial membrane antigen, and negative for alpha smooth muscle actin. A fusion gene, SYT-SSX was detected with reverse transcription-polymerase chain reaction. From the results, the secondary tumor was diagnosed as a synovial sarcoma. The current case of double sarcomas is rare. Both sarcomas were diagnosed accurately using immunohistochemical and molecular procedures. This case suggests a positive association between a second tumor and chemotherapy including intraarterial perfusion of doxorubicin.

Adult↗
PubMed1994

Phase II study of 5-fluorouracil/leucovorin for pediatric patients with malignant solid tumors.

BACKGROUND: 5-Fluorouracil (5-FU) activity for various carcinomas of adults has been enhanced through the synergistic effect of leucovorin. Few pediatric studies of 5-FU in pediatric patients have been previously reported. METHODS: Fifty-eight patients were treated with a 4-hour infusion of leucovorin, 400 mg/m2, administered daily for 5 days every 3-4 weeks. 5-Fluorouracil was administered by bolus injection 1 hour into each leucovorin infusion. Eleven adolescent patients with colorectal carcinoma, Stage 3 or 4, were treated with therapeutic intent, and other patients with a variety of drug-resistant pediatric solid neoplasms received similar treatment. RESULTS: Patients with measurable disease of colorectal carcinoma responded favorably to 5-FU/leucovorin. Stable disease activity was seen with other tumor types. Specifically, there were no objective responses in 12 patients with Ewing's Sarcoma or 11 with osteosarcoma. There were 4 deaths in this study from causes related to toxicity. Nonfatal grade 3/4 toxicities included mucositis, rash, myelosuppression, nausea, vomiting, diarrhea, and infection. CONCLUSION: The authors do not plan further evaluation of 5-FU/leucovorin in additional pediatric patients with colon cancer or other heavily pretreated malignant solid tumors and are presently treating their patients with colon carcinoma with 5-FU/leucovorin/interferon-alpha 2a.

Adolescent↗
PubMed1998

High complication rate of reconstruction using Ilizarov bone transport method in patients with bone sarcomas.

We performed five reconstructions by bone transport in patients with bone sarcoma: three osteosarcomas, one Ewing's sarcoma and one chondrosarcoma. Four sarcomas were in the distal femur and one in the shaft of the tibia. Four patients received multidrug chemotherapy. The average length of the skeletal defect after tumour resection was 17 (range 10-25) cm. All patients underwent double elongation from both proximal and distal sites of the bone defect. The average follow-up period was 48 (range 40-66) months, and the average duration of external fixation was 32 months (range 579-1340 days). In one case, bone formation was satisfactory, but in the other cases, it was poor and slow. The average treatment index was 95 (range 53-191) days per 1 cm of elongation. In one case, the bone fragment disappeared during the bone transport. In one case, the end of the bone protruded from the skin, and osteomyelitis set in. This patient underwent above-knee amputation due to failure of infection control. Three patients suffered talipes equinus. One patient died of pulmonary metastasis. Two patients had fair and three had poor function. This method is not recommended for patients with bone sarcoma who may have a poor prognosis, as it has an unacceptably high complication rate.

Adolescent↗
PubMed1990

Hemoblastoses in mice contaminated with low activities of 239Pu.

Female ICR mice were injected intravenously with low activities of 239Pu (3.0 kBq, 6.0 kBq, 12.3 kBq/kg). In these mice with high spontaneous incidence of hemoblastoses the occurrence of myeloid leukemia, lymphocytic leukemia, lymphosarcoma, reticulum-cell sarcomas and osteosarcoma was studied. Hemoblastoses, on the whole, remained in their numbers radiation-independent, nevertheless, the distribution into specific types changed, with moderate prevalence of myeloid and lymphocytic leukemia and lymphosarcoma. After plutonium injection the mean survival time of mice bearing myeloid and lymphocytic neoplasias was significantly shorter than the survival of mice that died of retothelosarcoma and from other causes. These contamination-dependent differences could not be observed in matched controls. As expected, 239Pu activities used in this experiment induced osteosarcomas. Whereas in leukemogenesis alpha-radiation appeared as a factor promoting and modifying the leukemogenic process, in osteosarcoma the alpha-particles acted rather as an initiator, the effect of which was dependent on the dose to the endosteal progenitor cells.

Animals↗
PubMed1988

Specific tissue targeting of polyoma virus oncogenicity in athymic nude mice.

Inbred athymic nu/nu mice (BALB/c and C57BL/6) were injected subcutaneously with polyoma virus A2 strain or with polyoma mutants which are able to infect undifferentiated embryonal carcinoma cells and harbor mutations in their enhancer sequences. Mammary adenocarcinomas were induced exclusively in females in which they represent the majority of the tumors. Both males and females developed sarcomas, mostly osteosarcomas, with a similar low frequency. No other type of neoplasm was observed. Mutations affecting the enhancers do not have any effect on the histotype of the tumors. Multiple copies of intact or defective free viral DNA were detected in all tumors. Such a sex-linked specific tissue targeting suggests a hormonal control of tumor initiation and/or promotion. From a pathological point of view, polyoma-induced adenocarcinomas are very similar to human early breast cancers. Tumor induction in nude mice by polyoma virus therefore represents a unique experimental model which differs from the more extensively used newborn immunocompetent mice.

Animals↗
PubMedDate not supplied

Antitumor chemosensitivity differs between clinical sarcoma and adenocarcinoma tissues.

The chemosensitivity of 43 human sarcoma tissues, including 18 osteosarcomas, 16 leiomyosarcomas and 9 liposarcomas, was compared with that of 28 adenocarcinomas of the stomach, using the in vitro succinate dehydrogenase inhibition (SDI) test. These tissues were exposed for 3 days to each antitumor drug, including adriamycin (ADM), 5-fluorouracil (5-FU), mitomycin C (MMC), cisplatin (CDDP), aclacinomycin A (ACR) and carboquone (CQ), them the cell viability was estimated based on the succinate dehydrogenase (SD) activity, determined using [3-(4,5-dimethyl-2-thiazolyl) -2,5-diphenyl-2H tetrazolium bromide] (MTT). SD activity was significantly lower in the osteosarcoma as compared to that in the adenocarcinoma, for ADM, MMC, CDDP, ACR and CQ (p < 0.01), and was higher for ADM (p < 0.05) in cases of leiomyosarcoma and for CDDP (p < 0.01) and ACR (p < 0.05) in cases of liposarcoma. The sensitivity rate was higher in osteosarcoma than in adenocarcinoma for ADM, MMC and CDDP. These findings suggest that patients with osteosarcoma will probably show a fairly good response to antitumor drugs, and that when liposarcoma or leiomyosarcoma tumors show resistance to antitumor drugs, then resection at the time of initial exploration and combined modalities, including radiation and hyperthermia, should be considered.

Adenocarcinoma↗
PubMed1977

Intratibial Moloney sarcoma virus-induced osteosarcoma in the rat: tumor incidence and pathologic evaluation.

Osteosarcomas were induced in approximately 80% of young New Zealand Black rats by the intratibial inoculation of Moloney murine sarcoma virus from day 1 to day 5 after birth. The neoplasms were composed of a spectrum of well-differentiated to poorly differentiated osteoblasts, osteocytes, and osteoclasts. Budding of C-type viral particles was associated with tumor induction. Compared to rats inoculated on day 1 after birth, rats inoculated at 4 days of age developed consistently more osteoproliferative bone tumors that often were associated with hypercalcemia, increased serum alkaline phosphatase, and elevated urinary hydroxyproline.

Animals↗
PubMed1995

Ultrasonographic monitoring of the effects of preoperative chemotherapy in osteosarcoma and Ewing's sarcoma.

This study evaluates ultrasonography as a method of monitoring the effect of preoperative chemotherapy on two types of tumour. Changes in the size of tumours of 15 patients (13 osteosarcoma, 2 extraosseous Ewing's sarcoma) were monitored by this method, and the results compared with the histological examination of the resected specimens. Six patients in whom the tumour size increased towards the end of chemotherapy showed in inadequate histological response, whereas 6 of the 7 patients in whom the tumour decreased in size had a good histological response. Ultrasonography is of value as it can indicate the effect of preoperative chemotherapy on sarcoma by monitoring the size of the tumour, and it is simple and cheap to use.

Adolescent↗