Unstratified chemotherapy for non-metastatic osteosarcoma of the extremities in children
Journal
Journal of the Formosan Medical Association
Journal Volume
102
Journal Issue
6
Pages
387-393
Date Issued
2003
Author(s)
Lin M.-T.
Hung I.-J.
Yang C.-P.
Chang T.-T.
Shu S.-G.
Chen R.-L.
Hsiao T.-C.
Chang W.-H.
Lin K.-H.
Abstract
Background and Purpose: The superiority of changing postoperative chemotherapy of osteosarcoma based on histological response of the primary tumor over non-tailored chemotherapy has not been confirmed. This multicenter study evaluated the effectiveness of an intensive unstratified chemotherapy regimen in Taiwanese children with osteosarcoma. Methods: Fifty patients younger than 18 years of age with previously untreated non-metastatic osteosarcoma of the extremities were enrolled. Patients were treated with pre- and postoperative chemotherapy, and surgery. Definitive surgery was scheduled in week 7 and postoperative chemotherapy was uniform without stratification regardless of histologic response. Results: Chemotherapy toxicities were considerable, but manageable. Treatment delay and decreased dose-intensity were common. There was one treatment-related mortality. Forty three patients (86%) received limb salvage surgery and 14 patients (33%) had a good histologic response to preoperative chemotherapy. With a median follow-up of 47.1 months, the 7-year event-free and overall survival rates were 51.6%, respectively. Conclusions: This was the first multicenter study on the treatment of osteosarcoma from Taiwan. The results suggest that a non-tailored regimen may serve as an alternative treatment strategy in the management of osteosarcoma, particularly when histologic assessment of the tumor response is not available.
SDGs
Other Subjects
aminotransferase; cisplatin; creatinine; cyclophosphamide; epirubicin; etoposide; folinic acid; methotrexate; antineoplastic agent; cisplatin; cyclophosphamide; epirubicin; etoposide; methotrexate; adolescent; adult; age; anemia; article; bone radiography; bone scintiscanning; cancer mortality; cancer survival; child; clinical article; computer assisted tomography; controlled study; diarrhea; drug fatality; febrile neutropenia; female; follow up; histopathology; human; infection; kidney dysfunction; leukopenia; limb salvage; liver dysfunction; male; medical assessment; mucosa inflammation; nausea and vomiting; nuclear magnetic resonance imaging; orthopedic surgery; osteosarcoma; postoperative care; preoperative care; Taiwan; thrombocytopenia; treatment outcome; bone tumor; clinical trial; limb; multicenter study; nonparametric test; osteosarcoma; preschool child; survival; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Child; Child, Preschool; Cisplatin; Cyclophosphamide; Epirubicin; Etoposide; Extremities; Female; Humans; Male; Methotrexate; Osteosarcoma; Statistics, Nonparametric; Survival Analysis; Taiwan; Treatment Outcome
Type
journal article