Postoperative whole lung irradiation with or without adriamycin in osteogenic sarcoma |
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| Authors: | M Zaharia E Caceres S Valdivia M Moran F Tejada |
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| Affiliation: | 1. Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru;2. Cancer Institute of Miami, U.S.A.;1. University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology/Head and Neck Surgery, The Netherlands;2. University of Groningen, Graduate School of Medical Sciences (Damage and Repair in Cancer Development and Cancer Treatment), The Netherlands;3. University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, The Netherlands;1. Adult Mesenchymal Tumor and Rare Cancer Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;2. The Royal Marsden Hospital and The Institute of Cancer Research, London, UK;3. Department of Radiology, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK;4. Radiology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;5. Palliative Care Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;6. Department of Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA;7. Medical Oncology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India;8. Department of Radiation Oncology, Dana-Farber Cancer Center/Brigham and Women''s Hospital, Boston, USA;9. Department of Medical Oncology, West German Cancer Center, Sarcoma Center, University of Duisburg-Essen, University Hospital, Essen, Germany;10. Orthopaedic Department, Regina Elena National Cancer Institute, Rome, Italy;11. Klinikum Stuttgart – Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart Cancer Center, Pädiatrische Onkologie, Hämatologie, Immunologie, Stuttgart, Germany;12. Department of Medical Oncology, Centre Leon Berard, Université Claude Bernard Lyon, Unicancer, Lyon, France;13. Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France;14. Nordix, Athens, Greece;15. Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands;16. Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway;17. Medical University Vienna & General Hospital Department of Internal Medicine 1/Oncology, Vienna, Austria;18. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;19. Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain;20. Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, Seville, Spain;21. The EHE Foundation, Wisconsin, USA;22. Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden;23. Orthopaedic Service, Musculoskeletal Oncology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;24. Medical Oncology Division, P.A. Herzen Cancer Research Institute, Moscow, Russian Federation;25. Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy;26. Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;27. Department of Pathology Brigham & Women''s Hospital, Boston, USA;28. University of Barcelona and Genitourinary Cancer and Sarcoma Unit Institut Català d''Oncologia, Hospitalet, Barcelona, Spain;29. Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands;30. University of Toronto and Lunenfeld-Tanenbaum Research Institute, Toronto, Canada;31. Department of Surgery, Centre Leon Berard, Lyon, France;32. Division of Medical Oncology, Candiolo Cancer Institute, FPO – IRCCS, Candiolo, Italy;33. NUY Langone Medical Center, New York, USA;34. Department of Radiotherapy, the Netherlands Cancer Institute, Amsterdam, the Netherlands;35. Department of Radiotherapy, the Leiden University Medical Center, Leiden, the Netherlands;36. Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla), Seville, Spain;37. Division of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany;38. Division of Molecular Pathology, The Institute of Cancer Research, London, UK;39. Department of Oncology, Helsinki University Hospital & Helsinki University, Helsinki, Finland;40. Department of Cancer, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK;41. Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium;42. University of Heidelberg, Mannheim University Medical Center, Sarcoma Unit, Mannheim, Germany;43. Musculoskeletal Oncology and Rehabilitation Medicine, Rare Cancer Center National Cancer Center Hospital, Tokyo, Japan;44. International Department, Gustave Roussy, Villejuif, France;45. UCLH - University College London Hospitals NHS Foundation Trust, London, UK;46. Department of Orthopaedics and Trauma Medical University Graz, Graz, Austria;47. Chair of Trustees of the EHE Rare Cancer Charity (UK), Charity number 1162472;48. Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain;49. Hospital Universitario Fundación Jimenez Diaz, Madrid, Spain;50. Unit of Soft Tissue and Bone Oncology, Division of Oncology, Tel-Aviv Medical Center affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;51. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA;52. Department of Clinical Epidemiology and Trial Organisation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;53. Sarcoma Group, Gustave Roussy, Villejuif, France;54. University of Pittsburgh Medical Center, Thomas Starzl Transplant Institute, Pittsburgh, USA;55. Oncology, CHUV Lausanne, Lausanne, Switzerland;56. Division of Abdominal Surgery, University Hospitals of Geneva, Geneva, Switzerland;57. Chemotherapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;58. Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy;59. Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA;60. Department of Medical Oncology, Institut Curie, Paris, France;61. Department of Surgery, Brigham and Women''s Hospital, Boston, USA;62. Center for Sarcoma and Bone Oncology, Harvard Medical School, Boston, USA;63. Dana Farber Cancer Center, Harvard Medical School, Boston, USA;64. Princess Margaret Cancer Centre and Sinai Healthcare System & Faculty of Medicine, University of Toronto, Toronto, Canada;65. Helios Klinikum Berlin-Buch, Department of Oncology and Palliative Care, Berlin, Germany;66. Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, USA;67. Maria Sklodowska-Curie National Research Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland;68. Aarhus University Hospital, Aarhus, Denmark;69. Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;70. Multi-Organ Transplant and HPB Surgical Oncology, Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada;71. Department of Pathology, Azienda Ospedaliera Università Padova, Padua, Italy;72. Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria;73. Leuven Cancer Institute, Leuven, Belgium;74. Department of Surgery, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK;75. University College London Hospital, London, UK;76. Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA;77. Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;78. Palliative Care, The Royal Marsden Hospital and The Institute of Cancer Research London;79. Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands;80. Department of Orthopedic Surgery Bone and Soft Tissue Tumor Unit, Leiden University Medical Center, Leiden, The Netherlands;81. Sarcoma and Melanoma Unit, The Netherlands Cancer Institute, Amsterdam, The Netherlands;82. Co-Chair of Sarcoma Patients EuroNet (SPAEN), Woelfersheim, Germany & Chairman of the Dutch organisation for sarcoma patients (Patiëntenplatform Sarcomen), Guest researcher at Leiden University (Leiden Institute for Advanced Computer Science), Leiden University, Leiden, The Netherlands;83. Chair of the Board of Directors of Sarcoma Patients EuroNet (SPAEN), Sarcoma Patients EuroNet (SPAEN), Woelfersheim, Germany;84. The Royal Marsden NHS Foundation Trust, London, UK;85. Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;86. Department of Supportive Care, Princess Margaret Cancer Centre and Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada;1. Department of Radiation Oncology, Comprehensive Cancer Center, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria;2. Department of Oncology, Aarhus University Hospital, Denmark;3. Department of Radiation Oncology, University Medical Centre Utrecht, The Netherlands;4. Department of Radiation Oncology, Leiden University Medical Center, The Netherlands;5. Departments of Oncology, Radiology and Gynae-oncology, Addenbrooke’s Hospital, Cambridge University Hospitals National Health Service Trust, United Kingdom;6. Radiation Oncology Department, Gustave Roussy Cancer Campus Grand Paris, France;7. Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India;8. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia;9. Cancer Centre, Mount Vernon Cancer Centre, United Kingdom;10. Department of Oncology, Oslo University Hospital, Oslo, Norway;11. Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;12. Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada;13. Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven, Belgium;14. Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands;15. Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, Montreal University, Montreal, Canada;1. GRC 5 Predictive Onco-Uro, Sorbonne University, AP-HP, Urology, Pitie-Salpetriere Hospital, Paris, France;2. Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK;3. University of Manchester, Manchester, UK;4. Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia;5. Department of Pathology, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria;6. Department of Pathology, Sorbonne University, AP-HP, Hôpital Tenon, Paris;7. Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain;8. Patient advocate, Bladder Cancer Norway, Norway;9. Department of Translational Medicine, Lund University, Malmö, Sweden;10. Department of Urology, Skåne University Hospital, Malmö, Sweden;11. Department of Urology, Edinburgh Bladder Cancer Surgery, Western General Hospital, Edinburgh, UK;12. Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK;13. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;14. Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France;15. Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany;p. Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;q. Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia;r. Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria;s. Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK;t. Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy;u. Department of Urology, Bichat-Claude Bernard Hospital, AP-HP, Université de Paris, Paris, France;v. Department of Urology, Université de Paris, AP-HP, Saint Louis Hospital, Paris, France |
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| Abstract: | ![]()
Thirty-six patients with histologically proven osteogenic sarcoma of the extremities, treated between September 1975 and April 1978, are the subject of this report. The primary tumor was treated with radical surgery. Patients received 2000 cGy whole lung irradiation postoperatively in an attempt to control micrometastases to the lung. Twenty-nine of the patients were given Adriamycin (60 mg/m2 IV every 6 weeks for a total dose of 550 mg/m2) in addition to the irradiation. The median, disease-free interval was 118 days for the seven patients treated with lung irradiation only. The median overall survival for these patients is 241 days, with one patient alive with disease. All patients developed lung metastasis. For the 29 patients treated with postoperative lung irradiation and Adriamycin, the median disease-free interval was 372 days, and the median overall survival is 843 days. Nineteen of the patients recurred (65.5%). The differences are statistically significant (p less than or equal to 0.003, median disease-free survival and p less than or equal to 0.03, median survival). This study supports the role of whole lung irradiation plus Adriamycin, in the control of micrometastases in osteogenic sarcoma of the extremities and suggests that additional clinical trials are warranted. |
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