title: Radiotherapy and gemcitabine-docetaxel chemotherapy in children and adolescents with unresectable recurrent or refractory osteosarcoma.
abstract: OBJECTIVE
  Few reports have described the treatment outcome of osteosarcoma using radiotherapy. We evaluated the efficacy of radiotherapy and gemcitabine and docetaxel chemotherapy for patients with unresectable recurrent or refractory osteosarcoma.
  
  
  METHODS
  Data from six patients (five male, one female) who received radiotherapy and gemcitabine and docetaxel chemotherapy at the Korea Cancer Center Hospital were retrospectively reviewed. Tumor response was evaluated according to metabolic changes using (18)F-fluorodeoxy-D-glucose-positron emission tomography.
  
  
  RESULTS
  The median age of the patients was 15.0 years (range, 14.0-15.8 years). Two patients had single bone lesions, and four had multiple metastatic bone lesions. Patients received a median 3.5 courses of gemcitabine and docetaxel chemotherapy (range, 2-6 courses). The median dose of radiotherapy was 50.0 Gy (range, 46-84 Gy). There were two complete metabolic responses and one partial metabolic response. The objective response rate was 50.0% (3/6). Responses were maintained for 4.6, 6.1 and 13.7 months, respectively. Patients were followed up for a median of 5.8 months (range, 2.7-84.6 months), and the median progression-free survival after this treatment was 3.6 months (range, 1.1-13.7 months). At the time of analysis, two patients were alive, one was lost to follow-up and three had died.
  
  
  CONCLUSIONS
  Radiotherapy with gemcitabine and docetaxel chemotherapy showed some improvement in cases of refractory tumors or multiple bone metastases. Further studies are needed to investigate the efficacy of newer radiotherapy modalities, as well as to identify new radiosensitizing chemotherapy regimens.
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul junahlee@kcch.re.kr.
authors.forename: Jun Ah
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Paik
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul.
authors.forename: Juhee
authors.initials: J
authors.lastname: Seo
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul.
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Diagnostic Radiology, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Yoo
authors.affiliation: Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul.
authors.forename: Mi-Sook
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012516:Osteosarcoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D056910:Republic of Korea; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D000093542:Gemcitabine
keywords: docetaxel; gemcitabine; osteosarcoma; radiotherapy