Complex treatment of patients with metastatic osteosarcoma, optimization of treatment algorithmSummary. The randomized trial to select the optimal treatment algorithm for patients with metastasis of osteosarcoma (OS) in lungs was carried out. 73 patients were divided into 2 groups based on preoperative of second-line chemotherapy in patients with metastases of OS. Was proposed the original regimen of chemotherapy with application of ifosfamіde, carboplatin, etoposide. The optimal treatment strategy for this group of patients is surgical removal of metastatic nodes followed by second-line chemotherapy with alternating blocks carboplatin + etoposide and ifosfamide + etoposide. Three-year overall survival in this group was 41.9% with a median of 24.6 months versus 26.5% and a median of 15.2 months in patients with preoperative and postoperative chemotherapy in the same way. Analysis of complications showed with statistically significantly lower rates of toxicity of second-line chemotherapy while maintaining its high efficiency.
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