title: A trial of chemotherapy in patients with osteosarcoma (a report to the Medical Research Council by their Working Party on Bone Sarcoma.
abstract: Two hundred and thirty five patients with osteosarcoma, aged less than 40 years, and treated by amputation or radiotherapy, were entered in a randomised trial of two forms of adjuvant chemotherapy. A two drug regimen, namely vincristine 2 mg m-2 (maximum 2mg) followed by methotrexate 200 mgm-2, given every three weeks, was compared with a three drug regimen, comprising the same vincristine-methotrexate treatment, alternating every three weeks with doxorubicin 60 mg m-2. Both regimens were continued for 54 weeks. Forty-one patients were excluded, most because of inadequate histology, leaving 194 patients for analysis. One hundred and seventy of these had immediate amputation, 14 were treated by a policy of radiotherapy, with surgery delayed for 9 months, provided no distant metastases had appeared, and 10 by a policy of radiotherapy only. Patients have been followed-up for between 26 and 94 months after entry to the trial. The 2- and 5-year survival rates were 48% and 27%. No significant difference in survival was observed between the two regimens, but toxicity was less with the two drug regimen.
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012516:Osteosarcoma / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D002955:Leucovorin; D008727:Methotrexate