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Preoperatively, the patients received moderate doses of methotrexate and cisplatinum-Regimen 1- or high dose methotrexate, cisplatinum and adriamycin-Regimen 2. Cisplatinum was delivered intra-arteriously, the other drugs intravenously. Limb salvage surgery was performed in 20 patients, and 2 patients were amputated. The surgical margins were adequate (radical or wide) in 18 cases and inadequate (marginal) in 4. The histologic response to chemotherapy was good (90% or more tumor necrosis) in 8 patients. In both regimens postoperative chemotherapy was tailored according to the grade of necrosis determined by preoperative treatment on the primary tumor. At an average follow-up of 40 months (15-70), 15 patients (68%) remained continuously disease-free and 7 relapsed with metastases. No local recurrences were observed. Regimen 2 was slightly more effective than Regimen 1 in terms of good histologic response (5\/10 vs 1\/12) and continuous disease-free survival (8\/10 vs 7\/127). The results demonstrate that, as in osteosarcoma, in non-metastatic malignant fibrous histiocytoma of bone in the extremities a high percentage of patients can be cured with neoadjuvant chemotherapy and that in most of them limb sparing surgery is possible and safe.<\/jats:p>","DOI":"10.1177\/030089169007600604","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T05:33:24Z","timestamp":1523943204000},"page":"537-542","source":"Crossref","is-referenced-by-count":10,"title":["Primary Chemotherapy and Delayed Surgery for Malignant Fibrous Histiocytoma of Bone in the Extremity"],"prefix":"10.1177","volume":"76","author":[{"given":"Gaetano","family":"Bacci","sequence":"first","affiliation":[{"name":"Centro di Chemioterapia Oncologica, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maddalena","family":"Avella","sequence":"additional","affiliation":[{"name":"Centro di Chemioterapia Oncologica, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Picci","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dante","family":"Dallari","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Malaguti","sequence":"additional","affiliation":[{"name":"Servizio di Radiologia, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Biagini","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Bailadelli","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Centro di Chemioterapia Oncologica, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizio","family":"Caldora","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Campanacci","sequence":"additional","affiliation":[{"name":"Centro Tumori Ossei, Istituto Ortopedico Rizzoli, Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1990,12,1]]},"reference":[{"key":"bibr1-030089169007600604","first-page":"431","volume":"6","author":"Avella M.","year":"1988","journal-title":"Minerva Ortop. 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