title: Pirarubicin-based chemotherapy displayed better clinical outcomes and lower toxicity than did doxorubicin-based chemotherapy in the treatment of non-metastatic extremity osteosarcoma.
abstract: Pirarubicin (THP) is a newer generation anthracycline anticancer drug with antineoplastic efficacy against numerous tumors. Few studies have reported its application and efficiency in anti-osteosarcoma chemotherapeutic strategies. Ninety-six non-metastatic extremity osteosarcoma patients treated with THP or doxorubicin (DOX) in combination with high-dose methotrexate (HDMTX), cisplatin (DDP) and ifosfamide (IFO) within the past 9 years at our hospital were evaluated retrospectively to compare efficacy and side effects. Among the patients, 55.2% were male, 36.5% were ≤14 years old and 59.4% presented with a large tumor (≥1/3 of bone) to our department. The 5-year disease-free survival (DFS) rate of the patients treated with the THP-based chemotherapeutic regimen was 70.2%, significantly higher than that of the DOX-based regimen-treated group (53.1%). The THP-based chemotherapeutic regimen decreased the lung metastatic rate significantly compared with the DOX-based regimen (19.1% vs. 36.7%, P=0.045), as well as the relapse rate (31.9% vs. 49.0%, P=0.067). Both regimens were generally well tolerated. However, while the THP-based chemotherapeutic regimen did not alter toxicity in the hematologic system, liver or kidneys compared with the DOX-based regimen, it showed lower rates of alopecia (63.8% vs. 85.7%, P=0.012), nausea and vomiting (51.1% vs. 79.6%, P=0.003), and mucositis (48.9% vs. 75.6%, P=0.003). THP also resulted in lower cardiac toxicity. Our data demonstrate that the THP-based regimen is better than the DOX-based regimen in terms of the 5-year DFS rate, pulmonary metastasis rate, relapse rate and side effects.
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Shuier
authors: S
authors: Zheng
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Shuhui
authors: S
authors: Zhou
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Guanglei
authors: G
authors: Qiao
authors: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Qingcheng
authors: Q
authors: Yang
authors: Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Zhichang
authors: Z
authors: Zhang
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Feng
authors: F
authors: Lin
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Daliu
authors: D
authors: Min
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Lina
authors: L
authors: Tang
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Hongtao
authors: H
authors: Li
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Yuanjue
authors: Y
authors: Sun
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Hui
authors: H
authors: Zhao
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Zan
authors: Z
authors: Shen
authors: Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
authors: Yang
authors: Y
authors: Yao
keywords: Osteosarcoma; chemotherapy; disease-free survival; doxorubicin; overall survival; pirarubicin; relapse; side effects
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