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Comparison of long-term outcome between doublet and triplet neoadjuvant chemotherapy in non-metastatic osteosarcoma of the extremity

 Hong S.  ;  Shin S.J.  ;  Jung M.  ;  Jeong J.  ;  Lee Y.J.  ;  Shin K.-H.  ;  Roh J.K.  ;  Rha S.Y. 
 ONCOLOGY, Vol.80(1-2) : 107-117, 2011 
Journal Title
Issue Date
Adolescent ; Adult ; Antineoplastic CombinedChemotherapyProtocols/therapeutic use* ; Bone Neoplasms/drug therapy* ; Bone Neoplasms/pathology ; Bone Neoplasms/surgery ; Child ; Child, Preschool ; Cisplatin/administration & dosage ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Extremities/pathology* ; Female ; Humans ; Ifosfamide/administration & dosage ; Kaplan-Meier Estimate ; Lung Neoplasms/secondary ; Male ; Middle Aged ; NeoadjuvantTherapy ; Neoplasm Recurrence, Local ; Neutropenia/chemically induced ; Osteosarcoma/drug therapy* ; Osteosarcoma/pathology ; Osteosarcoma/surgery ; Retrospective Studies ; Survival Rate ; Thrombocytopenia/chemically induced ; TreatmentOutcome ; Young Adult
Osteosarcoma ; Neoadjuvant ; Toxicity
OBJECTIVE: This study compared outcomes between doublet (AP) and triplet (IAP) neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremity.

METHODS: A total of 124 patients were enrolled. In the AP group, a doublet regimen of intraarterial cisplatin and intravenous doxorubicin was given to 77 patients from 1991 to 1999. In the IAP group, a triplet regimen of additional intravenous ifosfamide was given to 47 patients from 2000 to 2007. After completion of 3 cycles of chemotherapy, patients underwent surgery. We assessed tumor response according to pathologic tumor necrosis, and treated patients with further adjuvant chemotherapy.

RESULTS: The overall pathologic response was excellent with more than 90% tumor necrosis in 74.8% of patients. Total necrosis of tumors was also found in 46 (37.4%) patients. There was no difference between the 2 groups in pathologic response (75.3 vs. 72.3%; p = 0.52) or other clinicopathologic parameters. There was no difference between the 2 groups in recurrence rate (31.2 vs. 31.9%; p = 0.17) or lung metastasis (28.6 vs. 23.4%; p = 0.53). Moreover, there were no statistical differences in median disease-free survival and overall survival between the groups. There was more hematologic toxicity in the IAP group (neutropenia, p = 0.002; thrombocytopenia, p = 0.001; febrile neutropenia, p < 0.001).

CONCLUSIONS: The addition of ifosfamide to doxorubicin and cisplatin in neoadjuvant chemotherapy did not show improved outcomes in this study. Further trials are required to elucidate optimal neoadjuvant chemotherapy and effective salvage regimens
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Shin, Kyoo Ho(신규호)
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Lee, Young Joo(이영주)
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Jung, Jae Hun(정재헌)
Hong, Soo Jung(홍수정)
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