title: Clinical analysis of Chinese limb osteosarcoma patients treated by two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide.
abstract: OBJECTIVE
  The objective of this study was to investigate the efficacy and toxic side effects of two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide on treating Chinese osteosarcoma patients.
  
  
  METHODS
  A retrospective analysis was conducted of 185 osteosarcoma patients treated with the four drugs mentioned above. A total of 93 patients received the Italian therapeutic treatment (IOR-OS/N-5: Instituto Ortopedic Rizzoli-Section of Osteosacorma/Neoadjuvant chemotherapy-5) and the remaining 92 patients received the therapeutic treatment optimized by our department. We compared the efficacy and toxic side effects of these two therapies.
  
  
  RESULTS
  The limb salvage rates, 3-year recurrence rates and 3-year metastasis rates of IOR-OS/N-5 and our optimized treatment were 52.7 and 58.7%; 20.9 and 11.4% and 44.1 and 27.2%, respectively. The 3-year survival rates and the 3-year disease-free survival rates of IOR-OS/N-5 and our optimized treatments were 62.4 and 78.4%; and 53.6 and 67.8%, respectively. Overall survival and disease-free survival rates were significantly different between these two treatments (P = 0.032 and 0.024, respectively). Liver function with degree III and IV damage accounted for 35.2 and 16.6% of the total adverse reactions in the IOR-OS/N-5 and our optimized treatment groups, respectively. Degree III-IV neutropenia accounted for 22.6 and 40.0%, respectively, in the IOR-OS/N-5 and optimized treatments.
  
  
  CONCLUSIONS
  The optimization of MTX, DDP, DOX and IFO based on Chinese patients' physiology increased the tolerance and efficacy for the treatment of osteosarcoma.
authors: No. 6 People's Hospital of Shanghai Jiaotong University, Shanghai, China.
authors: Feng
authors: F
authors: Lin
authors: Qiong
authors: Q
authors: Wang
authors: Wenxi
authors: W
authors: Yu
authors: Lina
authors: L
authors: Tang
authors: Shuier
authors: S
authors: Zheng
authors: Yuanjue
authors: Y
authors: Sun
authors: Zan
authors: Z
authors: Shen
authors: Yang
authors: Y
authors: Yao
authors: Yang
authors: Y
authors: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002681:China; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004317:Doxorubicin; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate