Activity of intraarterial carboplatin as a single agent in the treatment of newly diagnosed extremity osteosarcoma.
BACKGROUND
Chemotherapy has dramatically improved the rates of cure and survival of patients with localized and metastatic osteosarcoma. Nonetheless, the number of chemotherapeutic agents active against osteosarcoma is limited to doxorubicin, cisplatin, high-dose methotrexate, and ifosfamide. Carboplatin, a cisplatin analogue, has been tested as a single agent in patients with recurrent osteosarcoma or as part of multiagent chemotherapy in newly diagnosed patients.


METHODS
We tested the activity and toxicity of two cycles of intraarterial carboplatin as a "window therapy" (600 mg/m2 per cycle) in 33 consecutive patients with extremity osteosarcoma before the start of multiagent chemotherapy. Response was based on clinical (tumor diameter, local inflammatory signs, and range of motion) and radiological parameters (plain local films and arteriographic studies prior to drug administration).


RESULTS
Patients' age ranged between 8 and 18 years (median age 13 years). Primary tumor originated from the femur (15 patients), tibia (10 patients), fibula (4 patients), humerus (3 patients), and calcaneus (1 patient). Only 7 patients (21%) had metastatic disease at diagnosis (5 in the lung and 2 in other bones). A favorable clinical and radiological response was documented in 81% and 73% of the patients, respectively. Clinical and radiological progression occurred in 12% and 9% of the patients, respectively. Seventeen of the patients remain alive and disease-free. Survival and event-free survival at 3 years for nonmetastatic patients are 71% (SE = 9%) and 65% (SE = 9%), respectively; for metastatic patients, the figures are 17% (SE = 15%) and 14% (SE = 13%), respectively.


CONCLUSIONS
We conclude that carboplatin is an active agent in the treatment of newly diagnosed extremity osteosarcoma.
Petrilli
A S
AS
Department of Pediatrics, Universidade Federal De São Paulo, São Paulo, Brazil. iopepm@dialdata.com.br
Kechichian
R
R
Broniscer
A
A
Garcia
R J
RJ
Tanaka
C
C
Francisco
J
J
Lederman
H
H
Odone Filho
V
V
Camargo
O P
OP
Bruniera
P
P
Pericles
P
P
Consentino
E
E
Ortega
J A
JA
D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002648:Child; D005121:Extremities; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D011859:Radiography; D016019:Survival Analysis
D000970:Antineoplastic Agents; D016190:Carboplatin