Osteosarcoma of the jaw/craniofacial region
Guadagnolo BA et al. - In a study to evaluate outcomes in pts with osteosarcoma of the head and neck (OHN) who were treated with surgery with or without radiotherapy (RT), it was determined that RT in addition to surgery improves overall survival (OS), disease-specific survival (DSS), and local control (LC) for pts with OHN who have positive/uncertain resection margins. Methods- 119 pts with OHN underwent macroscopic total resection with or without RT.
- Median age of the pts was 33 yrs.
- Of these 119 pts, 92 (77%) underwent surgery alone whereas 27 (23%) pts were treated with combined modality treatment (CMT) comprised of surgery and RT (median dose, 60 Gray [Gy]).
Results- Median follow-up was 5.8 yrs.
- OS rates at 5 and 10 yrs were 63% and 55%, respectively.
- Corresponding DSS rates were 67% and 61%, respectively.
- Stratified analysis by resection margin status demonstrated that CMT compared with surgery alone improved OS (80% vs 31%) and DSS (80% vs 35%) for pts with positive/uncertain resection margins.
- Multivariate analysis indicated that CMT for pts with positive/uncertain resection margins improved OS.
- 44 (36.97%) pts experienced local disease recurrence (LR) and 25 (21%) developed distant metastases (DM).
- There was no difference noted with regard to DSS if disease recurrence was isolated (LR vs DM: 26% vs 29%, respectively, at 5 yrs).
- Use of CMT vs surgery alone improved local control (LC) (75% vs 24%) for pts with positive/uncertain resection margins.
- Rate of surgical complications was 28% at 5 yrs.
- Rates of RT-associated complications were 40% and 47% at 5 and 10 yrs, respectively.
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