Chorney V. Optimization of combined treatment of osteosarсoma

Dissertation is devoted to study the feasibility of application in the treatment of OS patients of caffeine as a modulator of cytostatics and determined the prognostic value of serum VEGF, the degree of therapeutic pathomorphosis in the tumor. A correlation between the level of VEGF, therapeutic pathomorphosis and survival was determined. Indications and contraindications for limb-preserving and radical operations in accordance with tumor spreading chemotherapy efficacy and other features of disease were systematized and clarified. Also, for each tumor in different parts of the tubular bones of the upper and lower limbs list of methods of surgical treatment, the resection of the affected bone with replacement of bone defect endoprosthesis, autotransplantation with or without replacement of the defect was proposed. Their characteristics and indications for use were given. The study has proven that the evaluation of the effectiveness of treatment of OS and prognosis can be made by identifying primary level of serum VEGF and the degree of therapeutic pathomorphosis of tumor after chemotherapy. The positive correlation between serum VEGF level in patients before treatment and frequency of OS metastasis, and between serum VEGF levels and the amount of residual viable tumor parenchyma was observed. Individualized approach to use the adjuvant chemotherapy by the scheme of high-risk for patients of this category was corrected and specified.