Registration Number
0216U001137,
0113U002148
, R & D reports
Title
To develop and improve methods of prevention and treatment of metastatic relapses of high grade bone sarcomas .
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Head
Dyedkov Anatoliy,
Registration Date
25-01-2016
Organization
Ukrainian Research Institute of Oncology and Radiology
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Study object - lung metastases in patients with bone sarcomas (BS), treatment and prevention. The research was conducted based on results of treatment of 78 patients with lung metastases of BS diagnosed after treatment of primary lesions. Among them 46 (60.5%) were operable according to CT (study group), 32 (39.5%) - inoperable or who refuse surgery (control group). 59 patients had localized forms of high grade BS. The control group included 62 patients (historical control). Aim of study - to increase the treatment efficiency of primary bone malignancies and metastatic relapse by developing new and improving existing methods of neoadjuvant and adjuvant chemotherapy. Methods and apparatus - clinical, radiological, morphological, immunohistochemical, statistical; CT Somatom 4 Plus Siemens, Germany; MRI Magnetom Siemens; angiograph "Televiks"; ultrasonic diagnostic apparatus 90301710 US; Microscope Nikon Esclipe 80i. According to retrospective analysis of patients with distant metastases was developed diagnostic algorithm for selection of patients of high- risk group based on immunohistochemical markers of prognosis, spreading and localization of tumor. Was developed method of neoadjuvant chemotherapy for patients with high risk of metastasis, which includes thre-component regimen (methotrexate 12 g / m2, doxorubicin 75 mg / m2 cisplatin 120 mg / m2). Selection of persons of high risk of metastasis among patients with localized BS before treatment using complex prognostic factors (p53, VEGF, and localization in the bones of pelvis) allows to intensify chemotherapy and significantly decrease metastasis rate by 10.8% especially in this group during 2 years. Was developed second-line chemotherapy for the treatment of BS metastases - a combination of 3 drugs: carboplatin 450 mg/m2, etoposide 300 mg / m2, ifosfamide and 8 g/m2. The possibility of radical removal of lung metastases according to CT is a positive prognostic factor. 3-year survival rate in the study group was 32,3 ± 7,8%. The optimal complex treatment of these patients includes surgery followed by adjuvant chemotherapy due to the better survival of patients (35,8 ± 6,2)% vs. (28,4 ± 6,8)% and less toxicity of 2nd line chemotherapy Was proved the positive effect of bisphosphonates on the result of combined treatment of patients with BS. It creates favorable conditions for limb salvage surgery and reduces the risk of aseptic loosening of implants. BONES SARCOMAS, IMMUNOHISTOCHEMICAL MARKERS, LUNG METASTASES, NEOADJUVANT CHEMOTHERAPY, BISPHOSPHONATES.
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Бойчук Сергій Іванович
Ковальчук Павло Анатолійович
Костюк Віктор Юрійович
Новак Олена Милославівна
Тарасова Тетяна Олександрівна
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2020-04-02
