title: Neoadjuvant and adjuvant chemotherapy with doxorubicin and ifosfamide for bone sarcomas in adult and older patients.
abstract: The present study investigated the safety and efficacy of neoadjuvant and adjuvant chemotherapy with doxorubicin and ifosfamide for bone sarcoma in adult and older patients. A total of 18 consecutive patients with bone sarcoma (American Joint Committee on Cancer stage II in 14 patients and stage IV in four) treated with neoadjuvant and adjuvant chemotherapy at Nagoya Musculoskeletal Oncology Group hospitals in Japan between 2004 and 2011 were reviewed. The treatment efficacy and side-effects were evaluated. The responses to neoadjuvant chemotherapy were stable disease in 11 patients and progressive disease in three. Among the 12 evaluable patients, there were five with ≥90% tumor necrosis. The estimated overall survival (OS) rate at five years for the patients without metastasis prior to treatment was 56%. Major grade 3 or 4 side-effects included leukopenia in 14 cases, anemia in seven, thrombocytopenia in three, nausea in two and febrile neutropenia in two. One patient discontinued chemotherapy due to a temporarily depressed level of consciousness with arrhythmia (grade 2). The estimated five-year OS rate in this study was acceptable in patients without metastasis prior to treatment. A better coordinated prospective study of this combination regimen for older patients with bone sarcoma will be required to clarify its efficacy and tolerability.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Urakawa
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsukushi
authors.affiliation: Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.affiliation: Orthopedic Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Aichi 444-0011, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Orthopedic Surgery, Nagoya Memorial Hospital, Nagoya, Aichi 468-8520, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kozawa
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Arai
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Futamura
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
keywords: bone sarcoma; chemotherapy; doxorubicin; ifosfamide