Purpose of this study was to share our experience with combined therapy of patients with osteosarcoma of long tubular bones.

We have analyzed 173 patients with osteosarcoma-99 males and 74 females. The mean age was 18,5 years. Anatomical location included: femur-89 (51,4%) pts, tibia-41 (23,7%) pts, humerus-35 (20,2%) pts, other long tubular bones-8 (4,7%) pts. The following surgical procedures were performed: prosthetic reconstruction of the knee joint-71 (41,1%) pts, prosthetic reconstruction of the shoulder joint-14 (8,1%) pts, interscapular-thoracic resection-16 (9,2%) pts, segmental resection of bones with applying of Ilizarov’s device-4 (2,3%), amputations and exarticulations-68 (39,5%) pts.

In all patients we have carried out combined therapy. In case of lower extremity tumour localisation at the first stage we have performed intra-arterial preoperative chemotherapy of DOX 90 mg/m2 as 72-hour, at the second stage surgery. The histological response was evaluated according to Huvos score. Adjuvant chemotherapy in good responders (grade III-IV) comprised the drugs used preoperatively, in poor histological responders (grade I–II) CAP scheme. In some patients ifosfamide and etoposide were added. In case of upper extremity tumour localisation induction chemotherapy consisted of 3 cycles of CAP scheme, surgical treatment and adjuvant chemotherapy with CAP scheme (3 courses) in good responders. In poor histological responders we have added ifosfamide and etoposide.

At localised forms of osteosarcoma 5-years survival rate was 52,1±1,4%. Functional results are good in most patients. Without extra support move about 80% patients. At local-spread forms survival at 5-years is worse- 48,1±1,2%.

In patients with metastatic disease we have not observed full remission. Achieved results testify that combined therapy (surgery and chemotherapy) is optimum at treatment of patients with osteosarcoma at present day and permits to attain full recovery and to improve life quality of patients.

Aim of the research: generalization and optimization of methods of treatment of patient’s with fibrohistiocytic tumor of soft tissues.

Materials and methods: There were 79 (100%) patients under observation with malignant fibrohistiocytic tumor of soft tissue in the period from 2000 to 2006 year. There were 41 (51,9%) male and 38 (48,1%) female patients. The average age of patients were 45,5. Depending on localization of tumor on the lower extremities 47 (59,4%), on the upper extremities 19 (24%), trunk 13 (16,5%) of patients. Depending on histological structure of tumor the patients were distributed in the following way: 69 (87,3%) malignant fibrous histiocytoma, 10 (12,6%) atypical fibroxanthoma. In 49 (6,2%) cases were the initial tumor, at 30 (37%) were relapse tumor. In diagnostic used complex methods with including into investigation rentgenography, echography, USM, KT and MRT and morphological methods of research. The main methods of treatment are surgical, combine and complex. In initial and localized processes (the size of tumor < 5 cm) the main method is surgical (wide carving of tumor). The additional treatments to these patients did not make and they released under dynamic control. In our case there were 24 (30,4%) such kind of patients. In size of tumor from 5 to 10cm, and also in relapse at 17 (21,5%) patients on the first stage made surgical intervention, and then got distance gamma therapy (SOD 50Gy). In postoperative period conducted chemotherapy to 6 (7,5%) patients. In size of tumor more than 10cm in localization in upper extremities and trunk at 5(6,3%) patients the treatment begins with RT, and then surgical intervention +PXT by diagram CAPO, MAID, CAV II and others. In localization on lower extremities at 3 (3,8%) patients treatment begins with intra-arterial infusion Doxorubicin hydrochloride in 30mg/m2 during for 3 days (90mg/m2) and then surgical intervention +RT 50 Gy. At 18 (22,8%) patients were carving relapse, at 9 (11,5%) amputation, at 4 (5,1%) patients were exarticulation.