par Lejeune, Ferdinand 
;Klastersky, Jean ;Burny, Franz Léon ;Otten, Jacques
Référence Revue médicale de Bruxelles, 5, 8, page (551-558)
Publication Publié, 1984
;Klastersky, Jean ;Burny, Franz Léon ;Otten, Jacques Référence Revue médicale de Bruxelles, 5, 8, page (551-558)
Publication Publié, 1984
Article révisé par les pairs
| Résumé : | The authors present a new polydisciplinary approach to the treatment of osteosarcoma, in the light of the most recent data from the literature. Taking in example the osteosarcoma of the knee, they show the usefulness of pre- and post operative chemotherapy with limb saving surgery. Chemotherapy is based on high dose methotrexate (HDMTX)- 8 g/m2 for adolescents and adults, 12 g/m2 for prepubertal children. HDMTX is used as preoperative monotherapy and combined to Adriamycin(®), Bleomycin(®), Cyclophosphamide and Actinomycin D as postoperative polychemotherapy. The authors point out to the improvement achieved by the evaluation of the effect of HDMTX on the primary tumour. The degree of tumour lysis is established on histological criteria. If present, HDMTX will be continued postoperatively, otherwise it will be replaced by Cis-Platinum. Limb salvage is achieved by 'en bloc' dissection followed by the implantation of an endoprosthesis knee articulation and segment of femur diaphysis. The modalities of this polydisciplinary treatment are given. A high coordination is required in the team between chemotherapists and surgeons. The authors suggest that only 'ad hoc' polydisciplinary groups should embarque in this therapeutical approach. The first results which are presented look promising. |
