Background: to study the expression of Bcl-2 gene in osteogen sarcoma of long tubular bones and their effect on the disease prognosis.

Study was conducted in 20 patients with osteogen sarcoma of long tubular bones. Of 20 patients studied in 11 patients tumor was localized in femoral bone, in 6 patients in tibia and in 3 patients in fibula. Slices taken from the tumor in open biopsy were the object of research. Immune-hystochemical research was carried out by the standard technique applying antibodies to Bcl-2. The assessment response was made by visual simiquantity method: expression absence was-0, weak-1 (+), moderately expressed-2 (++), intensive-3 (+++). 17 patients were given chemoradiotherapy, 3 patients combined treatment (surgical + adjuvant chemotherapy). 12 got intraarterial chemotherapy (72 hours) by CAP regimen (Cyclophosphamide, Adriamycin, Cisplatin) – 4 cycles with three week interval. Then telegammatherapy, single dose 3.5 Gy up to general dose 60–70 Gy was made, later chemotherapy was completed up to 9 cycles at the same regimen. 8 patients were carried out 4 cycles of intra-arterial chemotherapy by MP regimen (Methotrexate, Cisplatin) with three week interval. Radiotherapy used subsequently (General dose 60–70 Gy) and chemotherapy was reached up to 9 cycles at the same regimen.

Research has shown, that in the most of patients 13/20 (65 %) had moderately positive and low positive expression of Bcl-2 gene, in 4/20 (20 %) cases reaction was negative and in 3/20 (15 %) cases it was the expression of the given gene that was high. The assessment of treatment efficiency was carried out by WHO recommendation. The whole effect was obtained in 6 patients (30 %), partial in 11 (55 %) and progressing was in 3 (15 %). Most patients who were given the treatment by specific scheme: chemotherapy + radiotherapy + chemotherapy had good parameters in life expectancy, where 6 of 8 patients (75 %) lived without relapse and metastases more than one year. All patients (3) had numerous lung metastases in operation + chemotherapy group of patients.

Aggressive current of tumoral process was characterized with high expression of Bcl-2 gene in tumor tissue. The level of expression Bcl-2 gene can testify the efficiency of conducted treatment.

It has been determined the prognostic importance of P-53 suppressor in 26 patients with osteogenous sarcoma of long tubular bones of lower extremities. Tumour localized in femoral bone in 14 observations (53,9%), in shin bone-11 (42,2%) and in fibular bone-1 (3,9%).

According to methods of treatment, all patients were divided into two groups:

I group: 18 patients received chemical and beam therapy. Treatment in this group was carried out by following scheme: intraneous metrotrexat, 25 mg/kg for 24 hours with leucovorin, intraneous cisplatin, 100 mg/m² for 4 hours. OOD-2,2Gy, SOD 60Gy beam therapy (telegammatherapy) was conducted after 4 courses of chemotherapy, 5 courses of chemotherapy by above-mentioned scheme was made after the end of beam therapy course.

Of 26 patients in 2 (7,8%) was noted complete effect, in 16 (61,5%) – partially effect, in 2 (7,8%) – stabilization of the process and in 6 (22,9%) – tumour progressing.

To estimate study results and determination of medicamental resistance of sarcoma there studied the rates of P-53 suppressor, as study results showed, in 6 (23%) observed moderate or high P-53 suppressor expression in tumor cells, and in 20 (77%) cases did negative and low-positive tumor or low negative and immunohistochemical tumor response. There established that low rates of P-53 suppressor correlated with high sensitivity of tumor to chemo-beam therapy, otherwise there obtained reverse reaction.

Conclusions: study results showed that P-53 suppressor rates have a significant importance in the determination of treatment strategy, tumor sensitivity to chemo-beam therapy and clinical outcome.