[Evaluation of adjuvant chemotherapy of osteosarcoma with special reference to adriamycin (final report)].

Adjuvant chemotherapy mainly with ADR performed in 117 patients (pts) with primary osteosarcoma of the extremity for the purpose of preventing pulmonary metastasis after radical ablative surgery. The mean follow-up period for 117 pts was 51.7 months (range: 3 to 137), for 53 survivors, 90.

[Rationale of preoperative chemotherapy of osteosarcoma].

The rationale of preoperative chemotherapy for osteosarcoma requires: eradication of microscopic metastatic foci which have already occurred in many patients with osteosarcoma, determination of a more effective form of postoperative adjuvant chemotherapy and easier and safer limb-salvage procedures through clearer marginal definition with reduction of primary lesions. In this paper, chemotherapeutic effects on the 5-year survival rate were analyzed for 49 patients with primary non-metastatic osteosarcoma of the extremities treated with radical surgery. The efficacy of preoperative chemotherapy was assessed in 11 cases of osteosarcomas treated with systemic chemotherapy as a preliminary study.

[Osteoporotic changes in rheumatoid arthritis].

Bone mineral density (BMD) in the distal 1/6 and 1/3 sites of the radius was measured by single photon absorptiometry in 58 female patients with rheumatoid arthritis, not treated with corticosteroids. Half of the patients showed lower values of BMD than those (mean--1SD) of age-matched controls. BMD decreased more significantly with advancement of destructive changes of radiocarpal joint in postmenopausal patients.

[Preoperative adjuvant chemotherapy of skeletal and soft tissue sarcomas].

Preoperative adjuvant chemotherapy for skeletal and soft tissue sarcomas requires: (1) correct identification of the effective postoperative adjuvant chemotherapy, (2) eradication of any of the micrometastatic foci that may have already occurred in many of the patients with these sarcomas, (3) easier and safer limb-salvage procedure, being clearly defined, with shrinkage of the primary lesion. For this purpose, a preoperative adjuvant chemotherapy regimen making practical use of intra-arterial CDDP (cis-dichlorodiammineplatinum II) infusion is desired in multi-drug combined chemotherapeutic treatment, including HDMTX (high-dose methotrexate), ADR (adriamycin) and CDDP. In this paper, the clinical application of preoperative adjuvant chemotherapy to skeletal and soft tissue sarcomas with combination of HDMTX and CDDP is presented in the light of the observations of tumor response to these anticancer agents, and the possibility of to establishing a new preoperative adjuvant protocol is discussed.

[Adjuvant chemotherapy for osteosarcoma in Japan--past, present and future].

The therapeutic results for osteosarcoma were very discouraging before 1970 in Japan despite many modes of treatment. In 1960, Miki introduced the regional perfusion technique into the treatment of osteosarcoma, and in 1963, Akaboshi pioneered the intraarterial infusion technique. By these methods, a five-year survival rate about 30% was achieved during the period from 1971 to 1976.

[Functional treatment of malignant bone tumors].

In treating malignant bone tumors of the limbs, what might be accepted as a reasonable therapy is preserving the functions of the affected limb, with controlling tumor both locally and systemically. Concerning giant cell tumor of bone (low malignancy), malignant fibrous histiocytoma of bone and primary or secondary chondrosarcoma (moderate malignancy) and osteosarcoma (high malignancy), surgical treatments to preserve the affected limb and to maintain it's function are going to be introduced with their actual applications mainly through clinical cases. In the treatment for osteosarcoma of the child, even after succeed in preserving the affected limb, there are some problems of the development of the limb, disorders of the local skin and soft tissue, and troubles concerning artificial materials.

Bone tumors in Japan.

The author organized the Japanese Registry of Bone Tumors; 27,665 bone tumors of various types were registered during the period from 1964 to 1980. The results of treatment by adjuvant multidrug chemotherapy for osteosarcoma in Japan were recorded; the five-year cumulative survival rate after treatment by multidrug chemotherapy is almost 70%. Among 82 patients with malignant fibrous histiocytoma, investigated with respect to treatment and prognosis, the five-year cumulative survival rate was 50.

Suppressive effect of elcatonin, an eel calcitonin analogue, on excessive urinary hydroxyproline excretion in polyostotic fibrous dysplasia (McCune-Albright's syndrome).

A 12-year-old Japanese girl with polyostotic fibrous dysplasia and endocrine concomitants, was treated with elcatonin, a synthetic eel calcitonin analogue, 10 MRC unit/twice a week given by intramuscular injection. Significant decreases in 24 hr urinary content of hydroxyproline and other amino acids from bone collagen were observed during the course of treatment over 5 months. This biochemical result suggests that the synthetic eel calcitonin analogue exhibits the therapeutic effect in patients with polyostotic fibrous dysplasia by inhibiting bone resorption.

Enzyme histochemical study on bone tumors.

A total of 19 cases with bone tumors, including six osteosarcomas. three giant cell tumors of bone, one malignant fibrous histiocytoma, four nonossifying fibromas, four chondromas and one chondrosarcoma, were examined as to enzyme histochemistry; the enzymes consisted of alkaline phosphatase (ALPase), acid phosphatase (ACPase), nonspecific esterase (NSE), adenosine triphosphatase (ATPase), 5'-nucleotidase (5'-Nucl) and beta-glucuronidase (beta-Gl). Osteosarcoma was strongly positive for ALPase followed by 5'-Nucl.

Characterization of human B lymphocyte specific antigens.

Anti-human B cell serum (ABS) was developed by sequentially absorbing a rabbit anti-human tonsil serum (AHTS) with human red cells, liver, serum, and thymocytes. AHTS was also absorbed quantitatively with tissues and cells from different sources. ABS was nontoxic for thymocytes but lysed the majority of chronic lymphocytic leukemia (CLL) cells.