[Intraarterial neoadjuvant chemotherapy for extremity osteosarcoma].
OBJECTIVE
To summarize the experiences in intraarterial neoadjuvant chemotherapy for extremity osteosarcoma.


METHODS
Between January 2002 and December 2007, 111 patients with stage IIB extremity osteosarcoma received preoperative intraarterial chemotherapy after placing chemotherapy pump subcutaneously, en bloc resection and postoperative adjuvant chemotherapy. There were 63 males and 48 females with an average age of 18 years old (range: 14 - 39). The time from symptom onset to hospitalization varied from several days to 6 months. The induction chemotherapy regimen included epirubicin [50 - 70 mg/m(2) by 4-hour intraarterial infusion/day for 3 days] and epirubicin plus adriamycin [100 - 120 mg/m(2) by 2-hour intraarterial infusion/day for 3 days] repetitively every 2 - 3 weeks. Among which 24 cases only received 2 cycles of induction chemotherapy was assigned into the nonstandard chemotherapy group and 87 cases receiving 3 - 6 cycles of induction chemotherapy the standard chemotherapy group. The number of preoperative chemotherapeutical cycles of standard chemotherapy group depended on the clinical and radiographic evaluation of chemotherapy efficacy.


RESULTS
The median follow-up time was 28 (8 - 48) months. The rate of extremity preservation surgery was 89.53% (77/86) in the standard chemotherapy group and 37.5% (9/24) in the nonstandard chemotherapy group. Kaplan-Meier survival analysis showed that the 3-year overall survival rate and disease-free survival rate of all 111 cases were 68.3% and 65.9% respectively. There were significant differences in overall survival rate (38.9%, 80.0%, P = 0.000), disease-free survival rate (30.1%, 79.5%, P = 0.000), distant metastatic rate (66.67%, 16.09%, P = 0.0000) and local recurrence rate (58.33%, 13.79%, P = 0.0000) between two groups.


CONCLUSIONS
Standard intraarterial neo-adjuvant chemotherapy is more effective than nonstandard intraarterial induction chemotherapy to treat stage IIB extremity osteosarcoma.
Liu
Yao-sheng
YS
Department of Orthopedics, PLA No. 307 Hospital, Beijing 100071, China.
Li
Ding-feng
DF
Liu
Shu-bin
SB
Cui
Qiu
Q
D000293:Adolescent; D000328:Adult; D001916:Brachial Artery; D002408:Catheters, Indwelling; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D015251:Epirubicin / Q000627:therapeutic use; D005121:Extremities; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery; D008297:Male; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000188:drug therapy*; D013348:Subclavian Artery; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D015251:Epirubicin; D004317:Doxorubicin