skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation

Abstract

The histologic response of an osteosarcoma to preamputation high-dose methotrexate therapy can be used to determine the optimum maintenance chemotherapy regimen to be administered after amputation. This study evaluates computed tomography (CT) as a method of assessing the response of the tumor to the methotrexate therapy. Nine patients with nonmetastatic osteosarcoma of an extremity had a CT scan of the tumor at initial presentation. This was compared with a second CT scan after four courses of high-dose intravenous methotrexate. Each set of scans was evaluated for changes in bony destruction, soft-tissue mass, pattern of calcification, and extent of tumor involvement of the marrow cavity. These findings were correlated with the histologic response of the tumor as measured by the degree of tumor necrosis. The changes seen on CT correlated well with the degree of the histologic response in seven of the nine patients.

Authors:
; ; ;
Publication Date:
Research Org.:
Indiana Univ. Medical Center, Indianapolis
OSTI Identifier:
5955456
Report Number(s):
CONF-8404240-
Journal ID: CODEN: AAJRD
Resource Type:
Conference
Resource Relation:
Journal Name: AJR, Am. J. Roentgenol.; (United States); Journal Volume: 144:1; Conference: Annual meeting of the Society for Pediatric Radiology, Las Vegas, NV, USA, 1 Apr 1984
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARMS; COMPUTERIZED TOMOGRAPHY; CHEMOTHERAPY; EVALUATION; LEGS; OSTEOSARCOMAS; NECROSIS; BONE TISSUES; HISTOLOGY; METHOTREXATE; PATIENTS; ANIMAL TISSUES; ANTIMETABOLITES; BODY; BODY AREAS; CONNECTIVE TISSUE; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; LIMBS; NEOPLASMS; PATHOLOGICAL CHANGES; SARCOMAS; SKELETAL DISEASES; THERAPY; TISSUES; TOMOGRAPHY 550602* -- Medicine-- External Radiation in Diagnostics-- (1980-)

Citation Formats

Mail, J.T., Cohen, M.D., Mirkin, L.D., and Provisor, A.J.. Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation. United States: N. p., 1985. Web.
Mail, J.T., Cohen, M.D., Mirkin, L.D., & Provisor, A.J.. Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation. United States.
Mail, J.T., Cohen, M.D., Mirkin, L.D., and Provisor, A.J.. 1985. "Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation". United States. doi:.
@article{osti_5955456,
title = {Response of osteosarcoma to preoperative intravenous high-dose methotrexate chemotherapy: CT evaluation},
author = {Mail, J.T. and Cohen, M.D. and Mirkin, L.D. and Provisor, A.J.},
abstractNote = {The histologic response of an osteosarcoma to preamputation high-dose methotrexate therapy can be used to determine the optimum maintenance chemotherapy regimen to be administered after amputation. This study evaluates computed tomography (CT) as a method of assessing the response of the tumor to the methotrexate therapy. Nine patients with nonmetastatic osteosarcoma of an extremity had a CT scan of the tumor at initial presentation. This was compared with a second CT scan after four courses of high-dose intravenous methotrexate. Each set of scans was evaluated for changes in bony destruction, soft-tissue mass, pattern of calcification, and extent of tumor involvement of the marrow cavity. These findings were correlated with the histologic response of the tumor as measured by the degree of tumor necrosis. The changes seen on CT correlated well with the degree of the histologic response in seven of the nine patients.},
doi = {},
journal = {AJR, Am. J. Roentgenol.; (United States)},
number = ,
volume = 144:1,
place = {United States},
year = 1985,
month = 1
}

Conference:
Other availability
Please see Document Availability for additional information on obtaining the full-text document. Library patrons may search WorldCat to identify libraries that hold this conference proceeding.

Save / Share:
  • Intravenous digital subtraction angiography (DSA) was performed in 23 patients with renal masses to document tumor extension into the main renal vein or inferior vena cava. The DSA findings were compared with computed tomographic as well as surgical and pathologic findings. Additional data regarding the number of renal arteries present and the relative vascularity of the tumor were also gathered. In 17 of 19 cases, single renal arteries to the affected kidney were correctly identified. In three patients, two renal arteries to the involved kidney were correctly identified. The renal masses were avascular in two patients, hypovascular in five, moderatelymore » vascular in eight, and hypervascular in seven. In one case the mass was out of the field of view, and vascularity was not evaluated. In these patients, DSA was an accurate and relatively noninvasive method to assist in the preoperative evaluation of renal masses.« less
  • Regional glucose metabolic rate constants and blood-to-brain transport of rubidium were estimated using positron emission tomography in an adolescent patient with a brain tumor, before and after chemotherapy with intravenous high-dose methotrexate. Widespread depression of cerebral glucose metabolism was apparent 24 hours after drug administration, which may reflect reduced glucose phosphorylation, and the influx rate constant for /sup 82/Rb was increased, indicating a drug-induced alteration in blood-brain barrier function. Associated changes in neuropsychological performance, electroencephalogram, and plasma amino acid concentration were identified in the absence of evidence of systemic methotrexate toxicity, suggesting primary methotrexate neurotoxicity.
  • The addition of methotrexate to a previously described regimen of cyclophosphamide, Adriamycin (doxorubicin), and high-dose vincristine (VAC) was tested in 50 evaluable patients with small cell bronchogenic carcinoma. Prophylactic whole brain radiation therapy was given during the first chemotherapy course and consolidation radiation therapy was given to the mediastinum and primary site after achieving partial or complete remission. The addition of methotrexate did not improve the incidence of complete remission as compared to a previous regimen without it. The addition of radiation therapy improved the local control rate. The high-dose vincristine in this and a previous CAV study improved themore » incidence of complete remission in both limited and extensive disease presentation as compared with the authors previous experience and induced an acceptable and reversible neurotoxicity. Moderate dose consolidation radiotherapy to the lung primary and mediastinum was effective in improving local control. The distinction between limited and extensive disease was found to be vague, as 22% of the patients could be shifted from one group to the other depending on definition. The evaluation of the various staging procedures indicates that bone scan gave a small number of truly abnormal tests. Isotopic brain and liver-spleen scan could be duplicated by computerized axial tomography (CAT). CAT scan of abdomen disclosed unexpected extension to the retroperitoneal nodes and adrenals.« less
  • Purpose: Three Phase II studies of preoperative radiotherapy and concurrent 5FU chemotherapy were undertaken. The primary endpoints were acute toxicity and pathologic complete response rate (pCR). Secondary endpoints were local recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS). Methods and Materials: A total of 134 patients with adenocarcinoma of the rectum (clinical T3/T4 or N1/N2) were treated. The initial cohort received 40 Gy in 20 fractions, the second 46 Gy in 23 fractions, and the third 50 Gy in 25 fractions. 5FU (225 mg/m{sup 2}/day) was given continuously throughout radiotherapy. A total of 121 patients underwent surgical resection.more » Results: Treatment was well tolerated. Grade 3/4 acute toxicity was observed in 13%, 4%, and 14% of patients in the 40 Gy, 46 Gy, and 50 Gy cohorts, respectively (p = 0.20). pCR was documented in 15%, 23%, and 33% of patients, respectively (p = 0.07). The 2-year actuarial LRFS was 72%, 90%, and 89% (p = 0.02); DFS was 62%, 84%, and 78% (p = 0.02); and OS was 72%, 94%, and 92%, respectively (p = 0.03). Conclusions: All treatment schedules were well tolerated. There was a trend toward increased pCR with higher doses. A statistically significant increase in LRFS, DFS, and OS was seen with radiation doses of 46 Gy and greater, but there was no difference between 46 Gy and 50 Gy.« less
  • Despite aggressive local therapy, advanced head and neck cancer continues to have a poor prognosis. In an attempt to improve survival in this disease, the Joint Center for Radiation Therapy and the Sidney Farber Cancer Institute instituted a pilot study employing high dose methotrexate with leucovorin rescue (3.5 to 7.5 g/m/sup 2/) as an adjuvant to aggressive radiotherapy and surgery. A high response rate of 60 percent (9/15) with no compromise of definitive therapy indicates such cooperation multimodality trials may hold promise for an increase in cure rates in these patients.