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KMID : 0613319970030030152
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Journal of the Korean Bone and Joint Tumor Soceity
1997 Volume.3 No. 3 p.152 ~ p.159
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Prediction of Survival in Osteosarcoma According to the Radiologic Response to Preoperative Chemotherapy
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Kim Jae-Do
Kwon Gi-Tak
Cho Myung-Rae
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Abstract
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Neoadjuvant chemotherapy has improved limb sparing surgery and survival in the treatment of osteosarcoma. The response to preoperative chemotherapy by Rosen’s modified T10 protocol was assessed in 40 patients with osteosarcoma. Plain X-ray, magnetic resonance imaging, angiogram and scintigram were used for this study. All studies were obtained before and after preoperative chemotherapy and were correlated with the histopathologic response and survival rate. The average duration of follow-up was 22 months and the average age of patients was 21 years. Thirty patients survived continuous disease free and one patient survived with disease. Nine patients died. Seven patients died of osteosarcoma, one patient died of other disease and one patient was lost to follow-up. The continuous disease free 5 year survival rate of 29 patients who were completed chemotherapy to our protocol was 76%. In plain X-ray 28 of 40[70%] showed good response and the survival rate was 95%, but the survival rate in 12[30%] of poor radiologic response was 17% [P=0.001]. In MRI [studied in 31 patients], 23 patients[74%] showed good response and the survival rate was 94%. The survival rate of poor response [8 of 31] was 35 % [P=0.001]. In angiographic study of 16 patients, the survival rate of good and poor responders was 65% and 45% respectively[ P=0.23]. In correlation with radiologic study and histopathological necrosis rate, MRI study was the most reliable method. In conclusion, radiographic evaluation [plain X-ray and MRI] of patients received chemotherapy for osteosarcoma is a valuable indicator in survival.
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KEYWORD
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Osteosarcoma, Pre-operative Chemotherapy, Radiologic Response
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