Efficacy of Pre- and Postoperative Chemotherapy in Patients with Osteosarcoma of the Extremities.
- Author:
Joo Hyuk SOHN
1
;
Sun Young RHA
;
Hei Cheul JEUNG
;
Hyun Joon SHIN
;
Young Suck GOO
;
Hyun Cheol CHUNG
;
Woo Ick YANG
;
Soo Bong HAHN
;
Kyu Ho SHIN
;
Jin Sik MIN
;
Byung Soo KIM
;
Jae Kyung ROH
;
Woo Ick JANG
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. jkroh@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Osteosarcoma;
Neoadjuvant chemotherapy;
Recurrence;
Metastasectomy
- MeSH:
Alkaline Phosphatase;
Chemotherapy, Adjuvant;
Cisplatin;
Doxorubicin;
Drug Therapy*;
Extremities*;
Follow-Up Studies;
Humans;
Metastasectomy;
Osteosarcoma*;
Recurrence;
Thorax;
Tomography, X-Ray Computed;
Treatment Outcome
- From:Cancer Research and Treatment
2001;33(6):520-526
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the treatment efficacy including survival and recurrence, and factors associated with recurrence in osteosarcoma patients treated with preoperative chemotherapy, surgery, and adjuvant chemotherapy. MATERIALS AND METHODS: Forty nine patients with osteosarcoma were treated with preoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion for 3 cycles, followed by surgery. According to the pathologic response, if tumor was necrotized more than 90%, the same adjuvant chemotherapy was reintroduced for 3 cycles, and if the response was not enough, then the salvage regimen was introduced. Plain chest film and chest CT scan were taken monthly and every 3 months, respectively. When tumor recurred, the metastasectomy was performed whenever possible. RESULTS: Forty three patients were evaluable with amedian follow up of 53 months. Five-year disease-free and overallsurvival rate was 47.0% and 66.9%, respectively. The recurrence was observed in 22 patients (51.2%) with median time of 12.5 months. Baseline alkaline phosphatase (ALP) was the only significant factor for recurrence (p=0.03) and the patients with the possibility of metastasectomy recurrence showed higher post-relapse survival compared to other treatment modalities (26 momths vs 5~12 months). CONCLUSION: These results indicates that pre- and postoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion showed comparable treatment efficacy and acceptable toxicities.
