EFFECT OF CHEMOTHERAPY ON SURVIVAL OF CRANIOFACIAL OSTEOSARCOMA - A SYSTEMATIC REVIEW OF 201 PATIENTS

Purpose: To evaluate the possible value of chemotherapy in the treatme nt of craniofacial osteosarcoma (CFOS), Design: In a systematic review , data of 201 patients (age, 36.6 +/- 19.0 years [mean +/- SD]) from 2 0 uncontrolled series on CFOS indexed in Medline and Excerpta Medico b etween 1974 and 1994 were pooled; 180 patients had undergone surgery, Various chemotherapy regimens had been given to 71 patients, Radiother apy was used in 69 patients, All patients had data for overall surviva l, and 182 had data for disease-free survival analysis, Cumulative sur vival distributions were estimated by the product-limit method, and a multiple regression analysis was performed, Results: Patients' overall and disease-free survival rates were significantly improved by treatm ent with chemotherapy, This was confirmed for patients with complete s urgical removal, as well as for those with incomplete removal of tumor , In a proportional hazards model, complete surgical removal and chemo therapy were independent significant factors for overall and disease-f ree survival, The effect of radiotherapy was insignificant, No prognos tic factors could be identified among age groups, sex, and subsites, C onclusion: Evidence exists that chemotherapy improves survival in CFOS , We advocate the adoption of the chemotherapy protocols used for OS o f the long bones for CFOS. (C) 1997 by American Society of Clinical On cology.