End results in reticulum cell sarcoma of bone treated by bacterial toxin therapy alone or combined with surgery and/or radiotherapy (47 cases) or with concurrent infection (5 cases)

Many factors which may affect prognosis in these 52 cases of reticulum cell sarcoma of bone have been reviewed. These include the type of toxin used and the technique of administration, the timing and dosage of radiotherapy, amputation, site and extent of the tumor, age and sex of the patient, and the possible role of concurrent complications, such as infections, inflammatory episodes, pregnancy, psychic or physical trauma. The evidence suggests that the most important factors were the stage and extent of the disease at onset of toxin therapy, the timing and dosage of radiotherapy, and the technique of toxin administration. With the availability of detoxified or concentrated preparations of various microbial products and a greater knowledge of the mechanisms of action involved in such therapy, it should be possible to secure a very high percentage of permanent results in these cases which have thus far yielded almost 50% better 5-year survival rates with such adjuvant therapy than have been obtained by surgery and/or radiotherapy alone.