Osteosarcoma is the most frequent malignant tumor of the bone in the pediatric age group, with an incidence of 8.7 per million in children and adolescent under the age of 20 years (Meyers and Gorlick, 1997). Its incidence peaks during the second decade of life, coinciding with the adolescent growth spurt. It is more commonly seen in the metaphyseal region of long bones; the distal femur, proximal tibia and proximal humerus being the most common sites and they correspond to areas of active growth in the body (Link and Eilber, 1989) Overall survival (OS) rates in nonmetastatic osteosarcoma were a dismal 10% prior to the 1970s when surgery was the only treatment option. Since the 1980s, the use of multidrug chemotherapy and refined surgical techniques
