Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: is a good response to preoperative treatment an indication to reduce postoperative chemotherapy?
Sixty-five patients with high grade central localized osteosarcoma of the extremities were treated according to a neoadjuvant chemotherapy schedule that was comprised of two methotrexate (MTX) cycles (high or moderate dosage) i.v. followed by cisplatinum (CDP) (continuous i.a. infusion for 24 hours). Thirty-four "good" responders (necrosis greater than 90%) were divide in two groups for post-operative treatment. The first group was treated for a short period (4 weeks) with i.v. MTX-CDP; the second group was treated for a longer period (24 weeks) with i.v. MTX-CDP and also adriamycin. Patients in the second group had far better results than the patients in the first group (19/19 vs. 5/15 continuously disease-free patients). Our results following this protocol indicate that even if patients are "good" responders to this neoadjuvant chemotherapy they should not undergo a shortened post-operative treatment, and the protocol should include adriamycin.
Bacci
G
G
Picci
P
P
Gherlinzoni
F
F
Van Horn
J R
JR
Orlandi
M
M
Normand
A R
AR
Manfrini
M
M
Pignatti
G
G
Campanacci
M
M
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage*; D005121:Extremities; D005260:Female; D005266:Femoral Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005360:Fibula; D006801:Humans; D006811:Humerus; D007223:Infant; D007231:Infant, Newborn; D007261:Infusions, Intra-Arterial; D007275:Injections, Intravenous; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D009336:Necrosis; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care; D013977:Tibia; D013997:Time Factors
D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate