Neoadjuvant chemotherapy for malignant fibrous histiocytoma of bone and for osteosarcoma of the limbs: a comparison between the results obtained for 21 and 144 patients, respectively, treated during the same period with the same chemotherapy protocol.
Twenty-one patients affected with malignant fibrous histiocytoma localized in the limbs were treated by pre- and postoperative chemotherapy (neoadjuvant). Preoperatively methotrexate (i.v.), cisplatinum (i.a.), and adriamycin (i.v.) were administered. Postoperatively the same drugs (in patients who responded well) or with the addition of ifosfamide and VP 16 (in those who responded poorly) were administered. Twenty resections and 1 amputation followed. The response to chemotherapy was good in 7 patients, and poor in 14. At a mean follow-up of 6.3 years 15 patients were disease-free and 6 had relapses. These results appear to be comparable to those for 144 patients affected with osteosarcoma of the limbs treated at the same time with the same protocol. The percentage of good responses and pulmonary metastases was higher in cases of osteosarcoma. Pre- and postoperative chemotherapy increases the percentage of healing in malignant fibrous histiocytoma. The lower percentage of good responses and the different type of relapse as compared to osteosarcoma indicate that preoperatively chemotherapy different from that used for osteosarcoma should be conducted.