Lin M.-T.KAI-HSIN LINDONG-TSAMN LINRONG-SEN YANGCHEN-TU WUMENG-YAO LUHung I.-J.Yang C.-P.Chang T.-T.Shu S.-G.Chen R.-L.Hsiao T.-C.Chang W.-H.Lin K.-H.2021-05-312021-05-3120030929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-0142168039&partnerID=40&md5=d0acb389b522b264b048ec60ab1dec3bhttps://scholars.lib.ntu.edu.tw/handle/123456789/563813Background 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]SDG3aminotransferase; 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 Outcomejournal article129235912-s2.0-0142168039