A complex chemotherapy regimen combined with repeated salvage surgeries can help maintain quality of life in patients with refractory recurrent maxillary osteosarcoma.
May support multimodal salvage strategies for QoL in refractory maxillary osteosarcoma; hypothesis-generating and requires prospective validation.
Osteosarcoma arising in the jaws is very rare, accounting for only about 7% of all osteosarcomas. A combination of chemotherapy and surgery has been reported to improve the survival rate of patients with osteosarcoma. We describe a case of locally aggressive osteosarcoma arising in the maxilla of a 51-year-old woman that recurred after operation and irradiation with carbon ions.CT scans revealed a huge tumor, destroying the middle skull base and invading the right temporal lobe.At presentation, the case was evaluated to be inoperable by a brain surgeon. Therefore, we performed high-dose methotrexate (MTX) citrovorum factor therapy combined with doxorubicin hydrochloride (DXR), cisplatin (CDDP), ifosfamide (IFM), vindesine sulfate (VDS), carboplatin (CBDCA), and caffeine (CAF). The tumor responded remarkably to chemotherapy, but proliferated again after the ninth course of chemotherapy. To maintain the patient's quality of life (QOL), partial resection was done 4 times with salvage chemotherapy. This regimen for chemotherapy was considered effective against osteosarcoma of the maxilla. The importance of standard treatment for osteosarcoma, including neoadjuvant chemotherapy, tumor resection, and adjuvant chemotherapy, was suggested.
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Yamano et al. (2007) studied this question.
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