In this review, recent advances in the clinical
therapy of
osteosarcoma, including results from the European
Osteosarcoma Intergroup trial demonstrating the efficacy of a short intensive two
drug protocol are discussed as well the evolving role of
ifosfamide. Biologically, the area of interest on chromosome 3q, which may contain an
osteosarcoma tumor suppressor gene, is being narrowed, and several promising new therapeutic approaches including
tumor vaccine have been explored. In
chondrosarcoma research, abnormalities in
hereditary multiple exostoses genes, which encode
protein products essential for normal cartilage development, and a potential mechanism for the characteristic
chemotherapy resistance of cartilaginous
tumors (overexpression of
P-glycoprotein) have been described. Surgical advances include testing of total en bloc spondylectomy for vertebral
tumors as well as a noninvasively extendable long bone
endoprosthesis. Finally, new insights in diagnostic imaging, including the evolving role of 201Tl, 99mTc-MIBI (methoxyisobutylisonitrile), and newer variations on magnetic resonance imaging are reviewed.