title: Addition of pamidronate to chemotherapy for the treatment of osteosarcoma.
abstract: BACKGROUND
  This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma.
  
  
  METHODS
  The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated.
  
  
  RESULTS
  For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances.
  
  
  CONCLUSIONS
  Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. meyersp@mskcc.org
authors.forename: Paul A
authors.initials: PA
authors.lastname: Meyers
authors.forename: John H
authors.initials: JH
authors.lastname: Healey
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Chou
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Wexler
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Merola
authors.forename: Carol D
authors.initials: CD
authors.lastname: Morris
authors.forename: Michael P
authors.initials: MP
authors.lastname: Laquaglia
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kellick
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Abramson
authors.forename: Richard
authors.initials: R
authors.lastname: Gorlick
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012516:Osteosarcoma / Q000188:drug therapy*; D000077268:Pamidronate
chemical_list: D004164:Diphosphonates; D004317:Doxorubicin; D000077268:Pamidronate; D002945:Cisplatin; D008727:Methotrexate