Preoperative Intra-Arterial Chemotherapy in Patients with Osteosarcoma: Case report of seven patients below the age of 18 years

Summary

In the period between 1987 and 1989, seven patients under 18 years of age with osteosarcoma of a lower limb were treated by preoperative intra-arterial chemotherapy. The age of the patients ranged from 12 to 17 years, the median age being 14.5 years. The polyethylene catheter was placed surgically into the lower epigastric artery. Two combinations of cytostatics were administered: adriamycin-bleomycin-cisplatin and high-dose methotrexate – vincristine – cisplatin. All patients, after two or three courses, underwent surgical resection of limb tumor. Tumor destruction ranged from 20 to 100%.

Four patients with necrosis from 80–100% remained free of disease from 18 to 30 months: two, having necrosis of 40% and 95% respectively, died. The youngest patient whose necrosis was as low as 20%, after completion of the systemic chemotherapy, developed local recurrence and pulmonary metastases.

Key Words::

• osteosarcoma
• intra-arterial chemotherapy