Abstract
Objective: The purpose of this study is to evaluate the efficacy of a four-drug regimen neoadjuvant chemotherapy for osteosarcoma with doxorubicin, cisplatin, methotrexate, and ifosfamide for patients ≤40 years of age with nonmetastatic osteosarcoma of the extremity.
Methods: From 1997 to 2012, 82 patients were evaluated. Treatment consisted of ten courses of chemotherapy and wide local excision. Preoperatively, patients received two courses of doxorubicin (90 mg/m2)/cisplatin (120 mg/m2) combination and high-dose ifosfamide (15 g/m2). Postoperatively, patients received two courses of doxorubicin/cisplatin combination, high-dose ifosfamide, and high-dose methotrexate (12 g/m2 on consecutive weeks).
Results: There were 2 patients with local recurrence, 17 patients with lung metastasis, and 1 patient with bone metastasis. At the last follow-up, 61 patients were continuously disease-free, 11 patients had no evidence of disease, 3 patients were alive with disease, 6 patients died of disease, and 1 patient died of treatment-related toxicity. The 5-year and 10-year event-free survival rates were 77 % and 73 %, respectively. The 5-year and 10-year overall survival rates were 95 % and 90 %, respectively.
Conclusion: A four-drug regimen neoadjuvant chemotherapy for osteosarcoma with doxorubicin, cisplatin, methotrexate, and ifosfamide was feasible. The survival rates were similar or better than previous studies. This study shows that this four-drug ten-course regimen can be an effective treatment for osteosarcoma.
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Acknowledgments
We acknowledge all the members of the Osaka University Orthopaedic Oncology Group for their input in this study: Hideki Hamada, Atsumasa Uchida, Ikuo Kudawara, Akihiko Matsumine, Akira Myoui, Shigeki Mori, Hideto Obata, Susumu Joyama, Noriyuki Tamai, Tsukasa Sotobori, Tetsuho Fujimoto, Kenichiro Hamada, Kazuya Oshima, Satoshi Tanenaka, Hidetatsu Outani, and Yoshinori Imura.
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Kakunaga, S. et al. (2016). Neoadjuvant Chemotherapy: Osaka University Osteosarcoma (OOS) Regimen. In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_8
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