[Pre and postoperative chemotherapy of osteosarcoma with an adriamycin-cisplatin combination. Risks of a neoadjuvant chemotherapy which is not sufficiently effective].
The authors evaluated a new protocol of neoadjuvant chemotherapy for osteosarcoma, easier to manage and different from T10. The good results obtained with the postoperative ADR-CDDP association led us to undertake a pilot study between 1982 and 1984, using ADR-CDDP as preoperative chemotherapy. The records of sixteen patients were available for follow-up. The average age of the patients was 19.9 years. Patients received two or three preoperative courses, and a total of six identical courses. Tolerance was good. Pain usually disappeared but this was often misleading because associated with radiological and/or clinical tumor progression, low histological necrosis or poor outcome. The continuous disease-free survival actuarial rate was less than 57 and 40% at 18 months and two years respectively. The actuarial survival rate was 87% at one year and 65% at two years respectively. Disappointing results of this preoperative protocol, compared to results with the SO4 78 or T10 protocols for example, led to publish these data early in order to underline their potential dangers. As a result, we stopped our study. The charter of pilot studies justifies this publication. As well, these data point out the necessity of very close follow-up of neoadjuvant chemotherapy by sophisticated medical imaging. Neoadjuvant chemotherapy, if ineffective, must be stopped early, and should lead to surgery, followed by adequate postoperative chemotherapy.
Delepine
N
N
Trifaud
A
A
Jasmin
C
C
Favre
R
R
Brun
B
B
Delepine
G
G
Tubiana-Hulin
M
M
Kerbrat
P
P
Dionet
C
C
Lucas
P
P
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D011379:Prognosis; D011859:Radiography
D004317:Doxorubicin; D002945:Cisplatin
Chimiothérapie de l'ostéosarcome par l'association adriamycine-cisplatinum pré et postopératoire. Risques de la chimiothérapie néoadjuvante lorsqu'elle n'est pas suffisamment efficace.