JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 53 No. 11                   2007

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Osteosarcoma arising in the jaws is very rare, accounting for oniy about 7 % of all osteosarcomas. A combination of chemotherapy and surgery has been reported to improve the survival rate of patients with osteosarcoma. We describe a case of locally aggressive osteosarcoma arising in the maxilla of a 51-year-old woman that recurred after operation and irradiation with carbon ions. CT scans revealed a huge tumor, destroying the middle skull base and invading the right temporal lobe. At presentation, the case was evaluated to be inoperable by a brain surgeon. Therefore, we performed high-dose methotrexate (MTX) citrovorum factor therapy combined with doxorubicin hydrochloride (DXR), cisplatin (CDDP), ifosfamide (IFM), vindesine sulfate (VDS), carboplatin (CBDCA), and caffeine (CAF). The tumor responded remarkably to chemotherapy, but proliferated again after the ninth course of chemotherapy. To maintain the patient's quality of life (QOL), partial resection was done 4 times with salvage chemotherapy. This regimen for chemotherapy was considered effective against osteosarcoma of the maxilla. The importance of standard treatment for osteosarcoma, including neoadjuvant chemotherapy, tumor resection, and adjuvant chemotherapy, was suggested. Key words: osteosarcoma, high dose Methotrexate therapy, maxilla, recurrence, multidrug combination chemotherapy

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