Edwin Choy, MD (Editor)
Harvard Medical School, MA, US

Series: Cancer Etiology, Diagnosis and Treatments
BISAC: MED062000

Before the use of chemotherapy, the treatment of localized osteosarcoma often involved amputation for local control of the disease. But even after definitive local control, the majority of patients would ultimately develop metastasis and die of this disease. Then, in 1974, Norman Jaffe, Emil Frei1, James Holland2, Gerald Rosen3,4, and others published reports demonstrating improved survival with adjuvant chemotherapy, given either before or after surgery.

Since then, with the increased use of adjuvant chemotherapy, the prognosis for patients improved until the 1990s, when the majority of patients diagnosed with nonmetastatic osteosarcoma were being cured. However, the prognosis for osteosarcoma when diagnosed today is still not significantly improved when compared to the 1990s. Additionally, for the 30-40% of patients who are either present with the metastatic disease or develop metastasis after initial surgery, the prognosis remains quite poor. We know that cytotoxic therapies, as a tool, are now being maximized. Additional cytotoxic therapy, either as dose dense or high dose chemotherapies or additional agents, do not seem to offer additional benefits above the standard regimens of “MAP” (methotrexate, adriamycin, cisplatinum) and “IE” (ifosfamide, etoposide). Therefore, new strategies to systemically treat osteosarcomas are still in great need despite the huge advances that were made in the 1970s.

This book is intended to give readers both a state of the art overview of the use of surgery and radiology in the treatment and diagnosis of osteosarcoma as well as an exploration of the frontiers of osteosarcoma research. By no means did we intend to offer a comprehensive review of all of the research and experimental strategies to improve osteosarcoma. We do not discuss in depth Mifamurtide (liposomal muramyl tripeptide phosphatidylethanolamine; L-MTP-PE), which is approved for commercial use in Europe. We also do not offer an extensive review of Samarium-153 lexidronam (153Sm-EDTMP), which is sometimes used to treat metastatic osteosarcoma, albeit with great toxicities. Both of those topics are already heavily reviewed and the reader will easily find sufficient literature to read about them. Rather, we sought to focus most of our chapters on the fringes of translational osteosarcoma research – topics that are promising but not completely in vogue — in hopes that we could stimulate interest and conversation in fields within the osteosarcoma research community that may open doors for additional collaborations and research. (Imprint: Nova Biomedical )