The role of clinical and imaging criteria in risk assessment during preoperative chemotherapy for osteosarcoma

: Prognosis for stage IIB osteosarcoma was evaluated versus the role of preoperative management of clinico-radiologic status in 293 patients. Three--five preoperative intra-arterial cycles of doxorubicin 90mg/m2 or cisplatin 120mg/m2 were given in 1986-1999, and later were followed by 3-4 cycles of doxorubicin and cisplatin in similar doses. Clinico-radiologic status was assessed in the course of preoperative chemotherapy. One hundred fifty patients were alive at the last examination, 139 had died of tumor progression, and 4 - chemotherapy complication. The two courses of preoperative chemotherapy were followed by more favorable outcome. Complete clinical response, tumors downsized to 300 mm, intra-osseous healing, periosteal assimilation and margination of extra-osseous masses had a significant positive impact on disease-free survival in the chemotherapy group. The data were used for the developing of models for individual risk evaluation and prognosis. Clinico-radiologic status monitoring in the course of preoperative chemotherapy is instrumental in predicting risks as well as designing alternative strategies of treatment at earlier stages.