Chemotherapy for Non-metastatic High-grade Osteosarcoma of Extremity—Is Neoadjuvant Better than Adjuvant?

RKC Ngan

Hong Kong J Radiol 2003;6:7-14

The addition of adjuvant or neoadjuvant chemotherapy to surgery revolutionises the treatment of high-grade non-metastatic osteosarcoma of the extremities. Overall 5-year survival of more than 50% to 60% is now a realistic achievable goal. Neoadjuvant chemotherapy possesses the theoretical advantages of optimising surgical results, providing early treatment of micrometastases, allowing histological assessment of chemotherapy, and customising postoperative chemotherapy. In this paper, the literature is reviewed to explore the existence of any comparative benefit of neoadjuvant over adjuvant chemotherapy for this disease entity.