Primary malignant tumors of bone.Evaluation of current diagnosis and treatment

The author's experience in the diagnosis and treatment of primary malignant bone tumors (700 cases) is reviewed, together with the experience of the staff at The University of Texas M. D. Anderson Hospital and Tumor Institute, to evaluate various approaches to diagnosis and treatment, and to determine whether progress has been made in treating bone sarcoma. The survival rates remain fairly constant and continue to be largely influenced by the adequacy of the surgery performed. Radiation therapy, while largely palliative, plays a role in adjunctive and definitive treatment (especially in reticulum cell sarcoma of bone). High energy forms of radiation therapy prove superior to ortho-voltage treatment. The clinical achievements of chemotherapy present scant evidence that it plays more than an adjunctive palliative role in the majority of cases treated. There is evidence that in some cases it may play an adjunctive role in successful treatment when used with radiation and/or surgery.