An opinion supporting the role of high-dose methotrexate in the treatment of osteosarcoma.

To properly assess the role of any drug for a specific disease, it would be prudent to examine the benefit to risk ratio of each drug. In this chapter these factors will be examined for not only high-dose methotrexate with leucovorin rescue, but also for the other currently useful drugs in the treatment of osteogenic sarcoma, namely, high-dose ifosfamide with mesna and cisplatinum combined with doxorubicin. Comments will be made about other proposed treatments that, at the current time, have no proven place in the treatment of patients with newly diagnosed primary osteosarcoma.