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Osteosarcoma treatment – Where do we stand? A state of the art review

Published:December 16, 2013DOI:https://doi.org/10.1016/j.ctrv.2013.11.006

      Abstract

      Long-term outcome for patients with high-grade osteosarcoma has improved with the addition of systemic chemotherapy, but subsequent progress has been less marked. Modern, multiagent, dose-intensive chemotherapy in conjunction with surgery achieves a 5-year event-free survival of 60–70% in extremity localized, non-metastatic disease. A major, as yet unsolved, problem is the poor prognosis for metastatic relapse or recurrence, and for patients with axial disease. This article reviews the current state of the art of systemic osteosarcoma therapy by focusing on the experiences of cooperative osteosarcoma groups. Also, we shed light on questions and challenges posed by the aggressiveness of the tumor, and we consider potential future directions that may be critical to progress in the prognosis of high-grade osteosarcoma.

      Abbreviations:

      OS (osteosarcoma), SEER (Surveillance Epidemiology and End-Results Program of the US National Cancer Institute), MSKCC (Memorial Sloan-Kettering Cancer Center), COG (Children’s Oncology Group), OAS (overall survival), EFS (event-free survival), HDMTX (high-dose methotrexate), (SSG) (Scandinavian Sarcoma Group), EURAMOS-1 (European and American Osteosarcoma Study Group 1 trial), MAP (high-dose methotrexate and doxorubicin and cisplatin), COSS (Cooperative Osteosarcoma Study Group), EOI (European Osteosarcoma Intergroup), SMNs (second malignant neoplasms), HER2/neu (human epidermal growth factor receptor 2), MAPK (mitogen-activated protein kinase), PI3K (phosphatidylinositol 3-kinase), MTP-PE (muramyl tripeptide phosphatidylethanolamine = mifamurtide), G-CSF (granulocyte-colony stimulating factor), IOR (Istituto Ortopedico Rizzoli), IFN-α (interferon alpha), POG (Pediatric Oncology Group), ISG (Italian Sarcoma Group), SFOP (Société Française D’oncologie Pédiatrique)

      Keywords

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