Interdisciplinary combined treatment of craniofacial osteosarcoma with neoadjuvant and adjuvant chemotherapy and excision of the tumour: a retrospective study

Abstract 

Osteosarcomas are highly malignant tumours of bone, and are rare in the craniofacial area. They account for only 1% of all head and neck malignancies. In this study we describe the treatment of 12 patients who were diagnosed with osteosarcoma of the mandible or maxilla between 1990 and 2004. These patients were given interdisciplinary treatments, either with a combination of neoadjuvant and adjuvant high-dose chemotherapy following the protocol of the cooperative osteosarcoma study group (COSS) with radical excision of the tumour (n=7), with a combination of radiation and radical excision (n=2), or with radical excision alone of the tumour (n=3). The 5-year survival of the group treated only by excision was 1 of 3, whereas that of the group treated by combination of chemotherapy and surgical removal was 7 of 7. The two patients treated with radiation and excision also lived 5 years after the end of the treatment, but had side-effects of radiation, whereas those treated with chemotherapy had no serious side-effects. We therefore conclude that combined interdisciplinary treatment of radical resection of the tumour with high-dose chemotherapy according to standard protocols is the most effective treatment for craniofacial osteosarcomas.

Keywords: Osteosarcoma, Maxillofacial surgery, Chemotherapy, COSS protocol, Head and neck cancer