Neoadjuvant chemotherapy & low dose extracorporeal irradiation for treatment of osteosarcoma

Abstract

9074 Background:Excision with bone cement followed by prosthetic replacement is the best line of treatment of osteosarcoma. A better substitute to higher costs of prosthesis is to give extracorporeal irradiation of resected specimen to be reimplanted again to assist stability of the bone matrix. Methods: 53 patients with osteosarcoma were selected for study.16 cases undergone excision+bone cement before prosthetic implant while 37 cases received ECI, 12 of which received low dose ECI (50 Gy) & 25 cases received high dose ECI(300 Gy). All cases received 3 cycles of neoadjuvant chemotherapy (CAP)* protocol. Results: Table 1: Recurrence rate after ECI was lower than excision+bone cement with prosthetic replacement neverseless metastases free survival and OAS were nearly identical. This difference didn’t reach statistical significance (P ≥ 0.203) Table 2: showed similar local tumor response with no significant difference (P ≥ 0.304). Table 3: Functional outcome with results nearly identical in subgroups Conclusions: ECI is considered a reasonable substitute to excision+prosthetic replacement for treatment of osteosarcoma with equivalent results as regard recurrence, MFS & OAS. More over the endpoint to this treatment with local control & functional outcome is nearly identical if we used low dose ECI & high dose ECI even low dose is beneficial for functional integrity & mechanical stability of bone. * cyclophosphamide, Adriablastin, Cisplatin No significant financial relationships to disclose.